Provider Demographics
NPI:1831555887
Name:SKLAR, NADAV RICK (MFT)
Entity type:Individual
Prefix:
First Name:NADAV
Middle Name:RICK
Last Name:SKLAR
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6176 AGEE ST UNIT 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3625
Mailing Address - Country:US
Mailing Address - Phone:805-452-7700
Mailing Address - Fax:
Practice Address - Street 1:6176 AGEE ST UNIT 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-3625
Practice Address - Country:US
Practice Address - Phone:805-452-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT30956106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist