Healthcare Provider Details

I. General information

NPI: 1700934247
Provider Name (Legal Business Name): NANCY BELL MAHANEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 RIVER PARK DR SUITE 205
SACRAMENTO CA
95815-4612
US

IV. Provider business mailing address

1555 RIVER PARK DR SUITE 205
SACRAMENTO CA
95815-4612
US

V. Phone/Fax

Practice location:
  • Phone: 916-564-6626
  • Fax: 916-565-0126
Mailing address:
  • Phone: 916-564-6626
  • Fax: 916-565-0126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY10665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: