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General NPI Number Information
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NPI Number | 1932684842
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Entity Type | Individual
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Provider Name | NAHAL NICHOLE HYDARYACIL PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 8 CORPORATE PARK STE 300
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City | IRVINE
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State | CA
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Zip | 92606-5196
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Country | US
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Telephone | 562-231-7022
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Fax |
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Provider Business Mailing Address
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Address Line | 4413 SHADEWAY RD
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City | LAKEWOOD
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State | CA
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Zip | 90713-3338
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Country | US
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Telephone | 714-721-7110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 108460
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License Number State | CA
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