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NPI Code Detail

MEDICARE: NICOLE ANDERS PSY.D.

MEDICARE:   NICOLE  ANDERS  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist28048CA

Other Identifiers

General Provider Information

NPI Number : 1053771105
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ANDERS PSY.D.
Provider Business Mailing Address
First Line : 6900 N PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6787 W TROPICANA AVE STE 241
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4759
Country : US
Telephone Number : 833-624-5400
Fax Number : 866-497-0441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2016
Last Update Date : 08/09/2022

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