Provider Demographics
NPI:1154467256
Name:WEBBER, NANCY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:E
Last Name:WEBBER
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 1:1494 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2504
Mailing Address - Country:US
Mailing Address - Phone:805-542-0954
Mailing Address - Fax:805-544-9273
Practice Address - Street 1:1494 MILL ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2504
Practice Address - Country:US
Practice Address - Phone:805-542-0954
Practice Address - Fax:805-544-9273
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9167103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY9167OtherLICENSED PSYCHOLOGIST