Provider Demographics
NPI:1659991792
Name:BIASOTTI, NANCY ANN
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ANN
Last Name:BIASOTTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N CLEVELAND ST APT 423
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2626
Mailing Address - Country:US
Mailing Address - Phone:760-579-8267
Mailing Address - Fax:
Practice Address - Street 1:117 N CLEVELAND ST APT 423
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-2626
Practice Address - Country:US
Practice Address - Phone:760-579-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-18
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health