Provider Demographics
NPI:1396965729
Name:COLENBAUGH, NANCY (MFT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:COLENBAUGH
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 1:706 MARGUERITE AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2342
Mailing Address - Country:US
Mailing Address - Phone:949-294-9593
Mailing Address - Fax:949-720-1168
Practice Address - Street 1:3501 JAMBOREE RD STE 470
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2916
Practice Address - Country:US
Practice Address - Phone:949-294-9593
Practice Address - Fax:949-720-1168
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist