Provider Demographics
NPI:1104026368
Name:NEAL, TARYN KIMBERLY (EDD, PSYCHOLOGIST)
Entity Type:Individual
Prefix:MS
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 1:2436 W COAST HWY
Mailing Address - Street 2:STE 103
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2436 W COAST HWY
Practice Address - Street 2:STE. 103
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
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:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist