Provider Demographics
NPI:1477620672
Name:HABER, NANCY L (MA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:HABER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 940414
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094
Mailing Address - Country:US
Mailing Address - Phone:805-657-3344
Mailing Address - Fax:
Practice Address - Street 1:123 HODENCAMP RD STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5833
Practice Address - Country:US
Practice Address - Phone:805-579-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35818106H00000X
CAMFC 35818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty