Provider Demographics
NPI:1427196245
Name:RARICK, NANCY KATHLEEN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KATHLEEN
Last Name:RARICK
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 1:10055 WOLF RD STE 4
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-8148
Mailing Address - Country:US
Mailing Address - Phone:530-519-6532
Mailing Address - Fax:530-892-2900
Practice Address - Street 1:10055 WOLF RD STE 4
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949
Practice Address - Country:US
Practice Address - Phone:530-894-5990
Practice Address - Fax:530-894-6416
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist