Healthcare Provider Details

I. General information

NPI: 1578357539
Provider Name (Legal Business Name): TAMARA NANCE, LMFT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

783 BASQUE WAY STE 108
CARSON CITY NV
89706-7981
US

IV. Provider business mailing address

1047 MARK WAY
CARSON CITY NV
89706-0612
US

V. Phone/Fax

Practice location:
  • Phone: 415-302-0056
  • Fax:
Mailing address:
  • Phone: 415-302-0056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAMARA NANCE
Title or Position: OWNER/PRESIDENT
Credential: LMFT
Phone: 415-302-0056