Healthcare Provider Details

I. General information

NPI: 1265297147
Provider Name (Legal Business Name): HANNAH ELIZABETH NYZNYK LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 ENCINITAS BLVD STE 248
ENCINITAS CA
92024-6792
US

IV. Provider business mailing address

1038 EVERGREEN DR
ENCINITAS CA
92024-3915
US

V. Phone/Fax

Practice location:
  • Phone: 310-874-2872
  • Fax:
Mailing address:
  • Phone: 310-874-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number133278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: