Provider Demographics
NPI:1740518802
Name:REITZ, NANCY NORTON (MPH,MSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:NORTON
Last Name:REITZ
Suffix:
Gender:F
Credentials:MPH,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 CAPISTRANO WAY
Mailing Address - Street 2:MARIPOSA HOUSE
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8550
Mailing Address - Country:US
Mailing Address - Phone:650-723-4577
Mailing Address - Fax:650-723-1977
Practice Address - Street 1:585 CAPISTRANO WAY
Practice Address - Street 2:MARIPOSA HOUSE
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-8550
Practice Address - Country:US
Practice Address - Phone:650-723-4577
Practice Address - Fax:650-723-1977
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 18643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health