Provider Demographics
NPI:1548479645
Name:KERR, NANCY ELLEN (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ELLEN
Last Name:KERR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 E MONTICELLO CIR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1879
Mailing Address - Country:US
Mailing Address - Phone:559-435-8427
Mailing Address - Fax:559-353-8177
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-8761
Practice Address - Country:US
Practice Address - Phone:559-353-5270
Practice Address - Fax:559-353-8177
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS172631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical