MEDICARE: NASTACIA RENEE PARHAM LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	115948	CA

General Provider Information

NPI Number	:	1144621582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NASTACIA RENEE PARHAM LMFT

Provider Business Mailing Address
First Line	:	3950 GARNET RD
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726-9517
Country	:	US
Telephone Number	:	530-416-8088
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 GARNET RD
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726-9517
Country	:	US
Telephone Number	:	530-903-8833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	02/28/2025

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