Provider Demographics
NPI:1801105259
Name:ZUCCANI, NANCY (MFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ZUCCANI
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 1:375 MOUNTAIN HOME ROAD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2569
Mailing Address - Country:US
Mailing Address - Phone:650-851-5474
Mailing Address - Fax:650-851-5474
Practice Address - Street 1:1101 EL CAMINO REAL
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066
Practice Address - Country:US
Practice Address - Phone:650-868-5158
Practice Address - Fax:650-851-5474
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18690106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist