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General NPI Number Information
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NPI Number | 1073390134
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Entity Type | Organization
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Legal Business Name | NANCY MACIAS
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 9040 TELEGRAPH RD STE 307
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City | DOWNEY
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State | CA
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Zip | 90240-2399
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Country | US
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Telephone | 213-461-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 8602 SAN JUAN AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-3114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | NANCY MACIAS
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Credential | LMFT
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Telephone | 213-461-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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