Provider Demographics
NPI:1972672954
Name:SALLEE, NANCY M (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:M
Last Name:SALLEE
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 MCBRYDE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1150
Mailing Address - Country:US
Mailing Address - Phone:510-215-1009
Mailing Address - Fax:510-215-1518
Practice Address - Street 1:759 APPIAN WAY
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2470
Practice Address - Country:US
Practice Address - Phone:510-367-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38611101YM0800X
HIMFT 154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health