Provider Demographics
NPI:1104026368
Name:NEAL, TARYN KIMBERLY (EDD, PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:TARYN
Middle Name:KIMBERLY
Last Name:NEAL
Suffix:
Gender:F
Credentials:EDD, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 QUAIL ST STE 125
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2773
Mailing Address - Country:US
Mailing Address - Phone:425-829-5435
Mailing Address - Fax:
Practice Address - Street 1:1000 QUAIL ST STE 125
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2773
Practice Address - Country:US
Practice Address - Phone:425-829-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27504103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling