Provider Demographics
NPI:1629204813
Name:NITCHIE, JUDITH ANNA (MFT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNA
Last Name:NITCHIE
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 1:1372 5TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2681
Mailing Address - Country:US
Mailing Address - Phone:415-665-5220
Mailing Address - Fax:
Practice Address - Street 1:1372 5TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2681
Practice Address - Country:US
Practice Address - Phone:415-665-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36770106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist