Provider Demographics
NPI:1134251630
Name:SALMAN, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SALMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUNDARI
Other - Middle Name:NANCY
Other - Last Name:SALMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:GRATON
Mailing Address - State:CA
Mailing Address - Zip Code:95444-0801
Mailing Address - Country:US
Mailing Address - Phone:707-775-0888
Mailing Address - Fax:
Practice Address - Street 1:3750 ACREAGE LN
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-9361
Practice Address - Country:US
Practice Address - Phone:707-775-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070751-1101YM0800X
CALCSW284331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health