Healthcare Provider Details

I. General information

NPI: 1265859219
Provider Name (Legal Business Name): NANCY R MADANI LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY R MADANI PSY.D., LMFT

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 10/27/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 E FOOTHILL BLVD
PASADENA CA
91107-3406
US

IV. Provider business mailing address

15792 MIDWOOD DR UNIT 2
GRANADA HILLS CA
91344-3234
US

V. Phone/Fax

Practice location:
  • Phone: 626-744-5230
  • Fax: 626-744-5242
Mailing address:
  • Phone: 818-900-3231
  • Fax: 818-825-5342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMFT78976
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT117232
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT139381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: