Provider Demographics
NPI:1003948118
Name:EDGAR, NANCY GAIL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:GAIL
Last Name:EDGAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1031
Mailing Address - Street 2:
Mailing Address - City:WILLOWS
Mailing Address - State:CA
Mailing Address - Zip Code:95988-1031
Mailing Address - Country:US
Mailing Address - Phone:530-934-8716
Mailing Address - Fax:
Practice Address - Street 1:600 A ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-3649
Practice Address - Country:US
Practice Address - Phone:530-757-5532
Practice Address - Fax:530-757-5533
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS202751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical