Provider Demographics
NPI:1952512386
Name:CHAPPLE, NANCI R (PSYD, MFT)
Entity Type:Individual
Prefix:DR
First Name:NANCI
Middle Name:R
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:PSYD, MFT
Other - Prefix:MRS
Other - First Name:NANCI
Other - Middle Name:RAE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1101 DOVE ST
Mailing Address - Street 2:# 240
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2839
Mailing Address - Country:US
Mailing Address - Phone:949-752-6462
Mailing Address - Fax:949-752-7636
Practice Address - Street 1:1101 DOVE ST
Practice Address - Street 2:# 240
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2839
Practice Address - Country:US
Practice Address - Phone:949-752-6462
Practice Address - Fax:949-752-7636
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC#33004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist