Provider Demographics
NPI:1497139570
Name:LE, NANCY (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:NANCY HONG
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1855 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2685
Mailing Address - Country:US
Mailing Address - Phone:347-455-0748
Mailing Address - Fax:
Practice Address - Street 1:1855 1ST AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2685
Practice Address - Country:US
Practice Address - Phone:347-455-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98555106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist