Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY32024 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY32024 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1033252283 |
---|---|
Provider Name | Ms. Misook Oh Nierodzik |
First Address | West Covina, CA 91791-1757 |
Second Address | West Covina, CA 91791-1757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 10/09/2020 |