Provider Demographics
NPI:1851514129
Name:TOMOOKA, NANCY ANN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:TOMOOKA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 PARK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1200
Mailing Address - Country:US
Mailing Address - Phone:541-485-2484
Mailing Address - Fax:
Practice Address - Street 1:2511 PARK FOREST DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1200
Practice Address - Country:US
Practice Address - Phone:541-485-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO683101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional