Provider Demographics
NPI:1588683049
Name:RHODES, NANCY R (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:R
Last Name:RHODES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E WALNUT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3865
Mailing Address - Country:US
Mailing Address - Phone:626-304-9353
Mailing Address - Fax:
Practice Address - Street 1:141 E WALNUT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3865
Practice Address - Country:US
Practice Address - Phone:626-304-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9901103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9901Medicare PIN