MEDICARE: NANAI FAMILY THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1740982727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANAI FAMILY THERAPY INC

Provider Business Mailing Address
First Line	:	6540 SCHMIDT LN UNIT D112
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-3276
Country	:	US
Telephone Number	:	650-422-9977
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 HEARST AVE STE 207
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-2260
Country	:	US
Telephone Number	:	650-422-9977
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARIA PAZ GONZALEZ CORDERO
Credential	:	LMFT
Telephone Number	:	650-422-9977

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/21/2023

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