Provider Demographics
NPI:1083855787
Name:RYAN, NANCY L (LMFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:RYAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10940 FAIR OAKS BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-5958
Mailing Address - Country:US
Mailing Address - Phone:916-426-2757
Mailing Address - Fax:
Practice Address - Street 1:10940 FAIR OAKS BLVD STE 600
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-5958
Practice Address - Country:US
Practice Address - Phone:916-426-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83937101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health