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Organization
OCEANSIDE PSYCHOLOGY CLINIC
Active
Organization
OCEANSIDE PSYCHOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
URVI NATHA PSY.D. (CLINICAL DIRECTOR/CEO)
(310) 944-1058
Entity
Organization
Contact information
Practice address
212 YACHT CLUB WAY STE A6, REDONDO BEACH, CA 90277-6907
(310) 956-1406
(424) 262-1008
Mailing address
P.O. BOX 3453, REDONDO BEACH, CA 90277
(310) 956-1406
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY27868
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
03/07/2017
Last updated
07/24/2019
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