Provider Demographics
NPI:1114561677
Name:PYZIK, NATHANIEL GABRIEL (LPCC)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:GABRIEL
Last Name:PYZIK
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3008
Mailing Address - Country:US
Mailing Address - Phone:650-762-8741
Mailing Address - Fax:
Practice Address - Street 1:1350 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3008
Practice Address - Country:US
Practice Address - Phone:650-762-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC10101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health