Provider Demographics
NPI:1700835923
Name:MARX, NANCY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:MARX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BOVET RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-3108
Mailing Address - Country:US
Mailing Address - Phone:650-562-1904
Mailing Address - Fax:650-508-0353
Practice Address - Street 1:155 BOVET RD
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3108
Practice Address - Country:US
Practice Address - Phone:650-562-1904
Practice Address - Fax:650-508-0353
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17090103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist