Healthcare Provider Details

I. General information

NPI: 1811163637
Provider Name (Legal Business Name): NANCY ELENA OBRIEN MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 PLEASANT HILL RD SUITE 110
PLEASANT HILL CA
94523-2003
US

IV. Provider business mailing address

116 ST LAURENT CT
MARTINEZ CA
94553-7205
US

V. Phone/Fax

Practice location:
  • Phone: 925-227-7713
  • Fax:
Mailing address:
  • Phone: 925-277-7713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number36254
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: