Provider Demographics
NPI:1043361819
Name:EWING, NANCY HELEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:HELEN
Last Name:EWING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE #9
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3661
Mailing Address - Country:US
Mailing Address - Phone:510-528-9955
Mailing Address - Fax:510-528-9945
Practice Address - Street 1:6500 FAIRMOUNT AVE
Practice Address - Street 2:SUITE #9
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3661
Practice Address - Country:US
Practice Address - Phone:510-528-9955
Practice Address - Fax:510-528-9945
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13540103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical