Healthcare Provider Details

I. General information

NPI: 1255265419
Provider Name (Legal Business Name): NANCY ELIZA CARO AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 N EUCLID AVE
UPLAND CA
91786-6038
US

IV. Provider business mailing address

PO BOX 1423
CHINO HILLS CA
91709-0048
US

V. Phone/Fax

Practice location:
  • Phone: 909-201-6997
  • Fax:
Mailing address:
  • Phone: 909-201-6997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: