MEDICARE: NANCY JEAN NAUNGAYAN

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790966299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY JEAN NAUNGAYAN

Provider Business Mailing Address
First Line	:	3815 MARCONI AVE
Second Line	:	SUITE 1
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-3867
Country	:	US
Telephone Number	:	916-485-4175
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 MARCONI AVE
Second Line	:	SUITE 1
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-3867
Country	:	US
Telephone Number	:	916-485-4175
Fax Number	:

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

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	11/26/2007

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