Provider Demographics
NPI:1881889541
Name:GLASS, NANCY JEAN (MFT MARRIAGE AND FM)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEAN
Last Name:GLASS
Suffix:
Gender:F
Credentials:MFT MARRIAGE AND FM
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Mailing Address - Street 1:1510 TOPANGA LANE
Mailing Address - Street 2:NANCY GLASS MFT NO 103
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8176
Mailing Address - Country:US
Mailing Address - Phone:559-799-8559
Mailing Address - Fax:916-409-0113
Practice Address - Street 1:1510 TOPANGA LANE
Practice Address - Street 2:NANCY GLASS MFT NO 103
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8176
Practice Address - Country:US
Practice Address - Phone:559-799-8559
Practice Address - Fax:916-409-0113
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAMFC022210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist