Provider Demographics
NPI:1912266461
Name:HAIK, NANCY BREEZY
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:BREEZY
Last Name:HAIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:BREEZY
Other - Last Name:GASPAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4433
Mailing Address - Country:US
Mailing Address - Phone:562-548-6500
Mailing Address - Fax:
Practice Address - Street 1:2934 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-1123
Practice Address - Country:US
Practice Address - Phone:559-549-6697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70955106H00000X
CA105089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist