Provider Demographics
NPI:1467835876
Name:MULLIN, NANCY MARIE (PSYD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:MULLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:MARIE
Other - Last Name:MULLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:1978 VIA APPIA
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3021 CITRUS CIR STE 240
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2691
Practice Address - Country:US
Practice Address - Phone:925-338-9135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33440103TC0700X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical