Provider Demographics
NPI:1457985244
Name:NEIDHARDT, NANCY LYNN (LMFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:NEIDHARDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 ESPLANADE STE 17A
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3366
Mailing Address - Country:US
Mailing Address - Phone:530-487-1282
Mailing Address - Fax:
Practice Address - Street 1:1430 ESPLANADE STE 17A
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3366
Practice Address - Country:US
Practice Address - Phone:530-487-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT129282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist