Provider Demographics
NPI:1922154293
Name:STAUFFER, NANCY BARNHART (MFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:BARNHART
Last Name:STAUFFER
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:PO BOX 23966
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3966
Mailing Address - Country:US
Mailing Address - Phone:858-204-0330
Mailing Address - Fax:
Practice Address - Street 1:591 CAMINO DE LA REINA STE 318
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3105
Practice Address - Country:US
Practice Address - Phone:858-204-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 12968106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist