Basic Information
| Provider Information | |||||||||
| NPI: | 1437353869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKS | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | PRITCHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD, MFT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LOGSDON | ||||||||
| OtherFirstName: | NANCY | ||||||||
| OtherMiddleName: | PARKS | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PHD, MFT | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 24445 HAWTHORNE BLVD | ||||||||
| Address2: | 105 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905056562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103735448 | ||||||||
| FaxNumber: | 3105173499 | ||||||||
| Practice Location | |||||||||
| Address1: | 24445 HAWTHORNE BLVD | ||||||||
| Address2: | 105 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905056562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103735448 | ||||||||
| FaxNumber: | 3105173499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC18511 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.