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NPI Code Detail

MEDICARE: NANCY B HERRON M.D.

MEDICARE: NANCY B HERRON M.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
12084P0804XChild & Adolescent Psychiatry Physician73571MA
22084P0800XPsychiatry PhysicianG131658CA

General Provider Information

NPI Number : 1780621367
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY B HERRON M.D.
Provider Business Mailing Address
First Line : 5021 KING PL
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-5030
Country : US
Telephone Number : 617-512-0380
Fax Number :
Provider Business Practice Location Address
First Line : 1287 FULTON RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4923
Country : US
Telephone Number : 707-800-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 10/07/2019

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