Provider Demographics
NPI:1174848691
Name:LAUGHLIN, NANCY A (MFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:A
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 HERITAGE LANE
Mailing Address - Street 2:SUITE 275
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815
Mailing Address - Country:US
Mailing Address - Phone:916-802-7659
Mailing Address - Fax:877-601-2202
Practice Address - Street 1:2011 P ST
Practice Address - Street 2:303
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5225
Practice Address - Country:US
Practice Address - Phone:916-802-7659
Practice Address - Fax:916-920-3557
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA46559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27-1655712OtherEIN