Provider Demographics
NPI:1124440847
Name:GIRGENTI, NANCY ANN (LICENSED MARRIAGE AN)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:GIRGENTI
Suffix:
Gender:F
Credentials:LICENSED MARRIAGE AN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 N ROSE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3245
Mailing Address - Country:US
Mailing Address - Phone:714-287-5030
Mailing Address - Fax:
Practice Address - Street 1:190 N ROSE BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3245
Practice Address - Country:US
Practice Address - Phone:714-287-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist