Provider Demographics
NPI:1952165920
Name:BATES, NANCY ANN (APCC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:BATES
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 S ASSOCIATED RD # 275
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5802
Mailing Address - Country:US
Mailing Address - Phone:424-744-1993
Mailing Address - Fax:
Practice Address - Street 1:7293 DUMOSA AVE STE 2
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3700
Practice Address - Country:US
Practice Address - Phone:760-365-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC15637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health