Provider Demographics
NPI:1376714949
Name:ESTES, NANCY L (MA,MFT,CT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:ESTES
Suffix:
Gender:F
Credentials:MA,MFT,CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 WAVE PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1127
Mailing Address - Country:US
Mailing Address - Phone:408-493-5300
Mailing Address - Fax:408-493-5300
Practice Address - Street 1:2117 CURTNER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-1308
Practice Address - Country:US
Practice Address - Phone:408-493-5300
Practice Address - Fax:408-493-5300
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist