Individual provider Active NPI

Jeffrey Edward Nalin, PSY.D.

  • Psychologist
  • Malibu, CA
National Provider Identifier
1114266863
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY17766 Issued in CA
Practice address
6323 Via Escondido Dr
Malibu, CA 90265-4484
Phone
(323) 314-9333
Fax
(310) 589-8866
NPI assigned
Jan 31, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY17766 CA Primary

Addresses

Primary practice location

6323 Via Escondido Dr
Malibu, CA 90265-4484

Mailing address

6323 Via Escondido Dr
Malibu, CA 90265-4484
Phone (323) 314-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY17766CAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1114266863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 VIA ESCONDIDO DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654484",
            "telephone_number": "323-314-9333",
            "fax_number": "310-589-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 VIA ESCONDIDO DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654484",
            "telephone_number": "323-314-9333",
            "fax_number": "310-589-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALIN",
        "first_name": "JEFFREY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY17766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malibu, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.