Provider Demographics
NPI:1245858026
Name:PHUNG-SMITH, NANCY (LMFT138181)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:PHUNG-SMITH
Suffix:
Gender:F
Credentials:LMFT138181
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 EL PASO ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-4302
Mailing Address - Country:US
Mailing Address - Phone:619-337-4176
Mailing Address - Fax:
Practice Address - Street 1:408 NUTMEG ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6214
Practice Address - Country:US
Practice Address - Phone:619-356-6388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA138181106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty