Healthcare Provider Details

I. General information

NPI: 1720492101
Provider Name (Legal Business Name): NANCY GINA ZANICCHI-BOBB M.A. COUNSELING PSYC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY GINA ZANICCHI

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3512 JOURNEY WAY
CLOVIS CA
93619-8036
US

IV. Provider business mailing address

3512 JOURNEY WAY
CLOVIS CA
93619-8036
US

V. Phone/Fax

Practice location:
  • Phone: 559-326-3583
  • Fax:
Mailing address:
  • Phone: 559-326-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number117004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: