Provider Demographics
NPI:1306059332
Name:NAIMARK, ANN (MFT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:NAIMARK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 ALHAMBRA BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3362
Mailing Address - Country:US
Mailing Address - Phone:916-442-5354
Mailing Address - Fax:916-442-7002
Practice Address - Street 1:418 ALHAMBRA BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3362
Practice Address - Country:US
Practice Address - Phone:916-442-5354
Practice Address - Fax:916-442-7002
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30446106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist