Provider Demographics
NPI:1437309796
Name:WHITE, NANCY A (LMFT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:SHERIDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13193 CENTRAL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4179
Mailing Address - Country:US
Mailing Address - Phone:909-902-9111
Mailing Address - Fax:909-902-9199
Practice Address - Street 1:13193 CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4179
Practice Address - Country:US
Practice Address - Phone:909-902-9111
Practice Address - Fax:909-902-9199
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40492106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist