Provider Demographics
NPI:1720492101
Name:ZANICCHI-BOBB, NANCY GINA (MA COUNSELING PSYC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:GINA
Last Name:ZANICCHI-BOBB
Suffix:
Gender:F
Credentials:MA COUNSELING PSYC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:GINA
Other - Last Name:ZANICCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3512 JOURNEY WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-8036
Mailing Address - Country:US
Mailing Address - Phone:559-326-3583
Mailing Address - Fax:
Practice Address - Street 1:3512 JOURNEY WAY
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-8036
Practice Address - Country:US
Practice Address - Phone:559-326-3583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist