Provider Demographics
NPI:1558423426
Name:FERRARIS, NINA M (MFT)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:M
Last Name:FERRARIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 N MAIN ST STE 365
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4641
Mailing Address - Country:US
Mailing Address - Phone:925-938-8889
Mailing Address - Fax:925-943-7919
Practice Address - Street 1:1655 N MAIN ST STE 365
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4641
Practice Address - Country:US
Practice Address - Phone:925-938-8889
Practice Address - Fax:925-943-7919
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT41546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist