MEDICARE: DR. NORA NAIM PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TF0000X	Family Psychologist	PSY27442	CA
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	PSY27442	CA
3	103TP0814X	Psychoanalysis Psychologist	PSY27442	CA
4	103TC0700X	Clinical Psychologist	PSY27442	CA

General Provider Information

NPI Number	:	1104066026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORA NAIM PSYD

Provider Business Mailing Address
First Line	:	1820 S CATALINA AVE STE 105
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5511
Country	:	US
Telephone Number	:	424-262-3512
Fax Number	:	424-267-0150

Provider Business Practice Location Address
First Line	:	1820 S CATALINA AVE STE 105
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5511
Country	:	US
Telephone Number	:	424-262-3512
Fax Number	:	424-267-0150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	09/17/2022

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