Provider Demographics
NPI:1144621582
Name:PARHAM, NASTACIA RENEE (LMFT)
Entity Type:Individual
Prefix:
First Name:NASTACIA
Middle Name:RENEE
Last Name:PARHAM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NASTACIA
Other - Middle Name:RENEE
Other - Last Name:MAGIDOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:3950 GARNET RD
Mailing Address - Street 2:
Mailing Address - City:POLLOCK PINES
Mailing Address - State:CA
Mailing Address - Zip Code:95726-9517
Mailing Address - Country:US
Mailing Address - Phone:530-903-8833
Mailing Address - Fax:
Practice Address - Street 1:1000 G ST STE 125
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-0894
Practice Address - Country:US
Practice Address - Phone:707-408-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115948106H00000X
390200000X
CAAMFT90779106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program