Healthcare Provider Details

I. General information

NPI: 1285519132
Provider Name (Legal Business Name): NAZANINE FOX AMFT 164870
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 JACKSON ST STE 102
LOS GATOS CA
95030-7171
US

IV. Provider business mailing address

10 JACKSON ST STE 102
LOS GATOS CA
95030-7171
US

V. Phone/Fax

Practice location:
  • Phone: 408-766-4290
  • Fax:
Mailing address:
  • Phone: 408-766-4290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: