Provider Demographics
NPI:1588796346
Name:SHEPPARD, NANCY L (LMFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:L
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10514 MONOGRAM AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6756
Mailing Address - Country:US
Mailing Address - Phone:818-681-6442
Mailing Address - Fax:323-257-6418
Practice Address - Street 1:7003 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1247
Practice Address - Country:US
Practice Address - Phone:323-543-4202
Practice Address - Fax:323-257-6418
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30280106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist