Provider Demographics
NPI:1700984028
Name:LEVI, NONIE ELIZABETH (MFT)
Entity Type:Individual
Prefix:MRS
First Name:NONIE
Middle Name:ELIZABETH
Last Name:LEVI
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 1:2310 DEERPARK DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1137
Mailing Address - Country:US
Mailing Address - Phone:619-276-0721
Mailing Address - Fax:
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE C113
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1703
Practice Address - Country:US
Practice Address - Phone:619-276-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34507106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist