Provider Demographics
NPI:1851540397
Name:NICHOLAS, NICOLE B
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:B
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 S EL CAMINO REAL STE 202
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6281
Mailing Address - Country:US
Mailing Address - Phone:442-500-8548
Mailing Address - Fax:760-400-8379
Practice Address - Street 1:2103 S EL CAMINO REAL STE 202
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6281
Practice Address - Country:US
Practice Address - Phone:442-500-8548
Practice Address - Fax:760-400-8379
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health