# OCEANSIDE PSYCHOLOGY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760922991
- **Authorized official:** URVI NATHA PSY.D. (CLINICAL DIRECTOR/CEO)
- **Authorized official phone:** (310) 944-1058

## Contact information

- **Practice address:** 212 YACHT CLUB WAY STE A6, REDONDO BEACH, CA 90277-6907
- **Practice address phone:** (310) 956-1406
- **Practice address fax:** (424) 262-1008
- **Mailing address:** P.O. BOX 3453, REDONDO BEACH, CA 90277
- **Mailing address phone:** (310) 956-1406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PSY27868 | CA | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | Yes |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |

## Other

- **Enumeration date:** 03/07/2017
- **Last updated:** 07/24/2019