Provider Demographics
NPI:1477801504
Name:NAUS, HOLLY M (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:NAUS
Suffix:
Gender:F
Credentials:MFT INTERN
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 698
Mailing Address - Street 2:
Mailing Address - City:APPLEGATE
Mailing Address - State:CA
Mailing Address - Zip Code:95703-0698
Mailing Address - Country:US
Mailing Address - Phone:916-765-4583
Mailing Address - Fax:
Practice Address - Street 1:320 H ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5834
Practice Address - Country:US
Practice Address - Phone:530-742-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAIMF93841106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)