Provider Demographics
NPI:1598900797
Name:PIPER, NANCY YVONNE (MFTI)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:YVONNE
Last Name:PIPER
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 GATHERING PL APT A
Mailing Address - Street 2:
Mailing Address - City:MIRA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91752-3195
Mailing Address - Country:US
Mailing Address - Phone:951-685-0958
Mailing Address - Fax:
Practice Address - Street 1:12202 GATHERING PL
Practice Address - Street 2:UNIT A
Practice Address - City:MIRA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91752-3195
Practice Address - Country:US
Practice Address - Phone:951-685-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist