Basic Information
| Provider Information | |||||||||
| NPI: | 1003001264 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARNATHAN-CRIBBS | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA | ||||||||
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| 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 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFT #44623 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.