Provider Demographics
NPI:1528826021
Name:SOUAYED, NADIA
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:SOUAYED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 W TEMPLE ST APT 209
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-7068
Mailing Address - Country:US
Mailing Address - Phone:310-990-2670
Mailing Address - Fax:
Practice Address - Street 1:438 CAMINO DEL RIO S STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3546
Practice Address - Country:US
Practice Address - Phone:855-550-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist