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General NPI Number Information
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NPI Number | 1942655634
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Entity Type | Individual
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Provider Name | TALIA JEAN NADEAU LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 327 E. REDWOOD AVE, SUITE 331-D
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City | FORT BRAGG
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State | CA
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Zip | 95437
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Country | US
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Telephone | 707-813-2104
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2808
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City | FORT BRAGG
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State | CA
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Zip | 95437
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Country | US
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Telephone | 915-745-5929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 86103
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT124500
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License Number State | CA
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