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NPI Code Detail

MEDICARE: MS. JUDY NIGHTINGALE PERSON MFT

MEDICARE: MS. JUDY NIGHTINGALE PERSON MFT
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
1106H00000XMarriage & Family TherapistMFC 021748CA

General Provider Information

NPI Number : 1841211406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUDY NIGHTINGALE PERSON MFT
Provider Business Mailing Address
First Line : 851 FREMONT AVE
Second Line : 214
City : LOS ALTOS
State : CA
Zip : 94024-5698
Country : US
Telephone Number : 408-496-1513
Fax Number : 408-733-1953
Provider Business Practice Location Address
First Line : 851 FREMONT AVE
Second Line : 214
City : LOS ALTOS
State : CA
Zip : 94024-5698
Country : US
Telephone Number : 408-496-1513
Fax Number : 408-733-1953
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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Directions to “ MS. JUDY NIGHTINGALE PERSON MFT” Practice Location

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