Provider Demographics
NPI:1063840031
Name:NIERENBERG, JAMIE LEIGH (PSYD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIGH
Last Name:NIERENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1891 EFFIE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1793
Mailing Address - Country:US
Mailing Address - Phone:323-644-2000
Mailing Address - Fax:
Practice Address - Street 1:1891 EFFIE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1793
Practice Address - Country:US
Practice Address - Phone:323-644-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program