Provider Demographics
NPI:1831247295
Name:MAZZANTI, NANCY ANN (MFT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:MAZZANTI
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 1:235 PIEDMONT LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1413
Mailing Address - Country:US
Mailing Address - Phone:925-519-4530
Mailing Address - Fax:925-820-9146
Practice Address - Street 1:419 ELIZABETH ST
Practice Address - Street 2:#6
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4607
Practice Address - Country:US
Practice Address - Phone:925-519-4530
Practice Address - Fax:925-820-9146
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27957106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist