Provider Demographics
NPI:1427325992
Name:NOCIFERA, NAMI MIA (LCSW)
Entity type:Individual
Prefix:
First Name:NAMI
Middle Name:MIA
Last Name:NOCIFERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NAMI
Other - Middle Name:MIA
Other - Last Name:D'ANGELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 2638
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90294-2638
Mailing Address - Country:US
Mailing Address - Phone:805-570-5509
Mailing Address - Fax:
Practice Address - Street 1:4052 DEL REY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5681
Practice Address - Country:US
Practice Address - Phone:805-570-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA612001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker