| Doctor Name: | DR. NANCY NOVACK |
| NPI Number: | 1053418210 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY15655 |
| Business Practice Address: | 240 Almonte Blvd Mill Valley, CA - 949413563 |
| Business Phone Number: | 4153833058 |
| Business Fax Number: | 4153835306 |
| Mailing Address: | 240 Almonte Blvd, MILL VALLEY |
| State: | CA |
| Postal Code: | 949413563 |
| Phone Number: | 4153833058 |
| Fax Number: | 4153835306 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY15655 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |