Basic Information
Provider Information
NPI: 1003001264
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARNATHAN-CRIBBS
FirstName: NANCY
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1105 SEAVIEW AVE
Address2:  
City: PACIFIC GROVE
State: CA
PostalCode: 939505211
CountryCode: US
TelephoneNumber: 8317474383
FaxNumber: 8316214720
Practice Location
Address1: 170 17TH ST
Address2: SUITE B
City: PACIFIC GROVE
State: CA
PostalCode: 939507201
CountryCode: US
TelephoneNumber: 8317474383
FaxNumber: 8316214720
Other Information
ProviderEnumerationDate: 09/11/2007
LastUpdateDate: 04/15/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMFT #44623CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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