Provider Demographics
NPI:1295518512
Name:MCCRAY, NANCY (PSYD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:CHESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5055 BUSINESS CENTER DR. STE 108 #451
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-0027
Mailing Address - Country:US
Mailing Address - Phone:408-641-9920
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:773-240-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005647103T00000X
CA34445103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist