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NPI Code Detail

MEDICARE: MR. RON REED NICHOLS

MEDICARE: MR. RON REED NICHOLS
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1275858383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RON REED NICHOLS
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number : 415-861-0257
Provider Business Practice Location Address
First Line : 2210 CLAY ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-1930
Country : US
Telephone Number : 415-776-4647
Fax Number : 415-776-1018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2010
Last Update Date : 03/31/2010

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