Provider Demographics
NPI:1437353869
Name:PARKS, NANCY PRITCHARD (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:PRITCHARD
Last Name:PARKS
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:PARKS
Other - Last Name:LOGSDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MFT
Mailing Address - Street 1:24445 HAWTHORNE BLVD
Mailing Address - Street 2:105
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6562
Mailing Address - Country:US
Mailing Address - Phone:310-373-5448
Mailing Address - Fax:310-517-3499
Practice Address - Street 1:24445 HAWTHORNE BLVD
Practice Address - Street 2:105
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6562
Practice Address - Country:US
Practice Address - Phone:310-373-5448
Practice Address - Fax:310-517-3499
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18511106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist