Provider Demographics
NPI:1770243230
Name:AIKIN, NANCY (PHD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:AIKIN
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 1:1107 OVEJAS AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1900
Mailing Address - Country:US
Mailing Address - Phone:530-758-1912
Mailing Address - Fax:
Practice Address - Street 1:1107 OVEJAS AVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1900
Practice Address - Country:US
Practice Address - Phone:530-758-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-26
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10542103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist