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NPI Code Detail

MEDICARE: NANCY MARIE MULLIN PSY.D.

MEDICARE: NANCY MARIE MULLIN PSY.D.
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
1103TC0700XClinical PsychologistPSY33440CA

General Provider Information

NPI Number : 1467835876
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY MARIE MULLIN PSY.D.
Provider Business Mailing Address
First Line : 1978 VIA APPIA
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3021 CITRUS CIR STE 240
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2691
Country : US
Telephone Number : 925-338-9135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2015
Last Update Date : 08/26/2023

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