Provider Demographics
NPI:1184850604
Name:PADBERG, NANCY ALPHA (MA, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ALPHA
Last Name:PADBERG
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:ALPHA
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LCSW
Mailing Address - Street 1:16756 CHINO CORONA RD
Mailing Address - Street 2:P.O. BOX 6000 CORONA,CA 92878-6000
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9508
Mailing Address - Country:US
Mailing Address - Phone:909-597-1771
Mailing Address - Fax:909-303-8087
Practice Address - Street 1:16756 CHINO CORONA RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-9508
Practice Address - Country:US
Practice Address - Phone:909-597-1771
Practice Address - Fax:909-303-8087
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical