Provider Demographics
NPI:1417057837
Name:FABER, NANCY GAY (MFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:GAY
Last Name:FABER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94914-0742
Mailing Address - Country:US
Mailing Address - Phone:415-461-3522
Mailing Address - Fax:415-461-0360
Practice Address - Street 1:45 VIA BELARDO
Practice Address - Street 2:#10
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2236
Practice Address - Country:US
Practice Address - Phone:415-461-3522
Practice Address - Fax:415-461-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35487106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist