Healthcare Provider Details

I. General information

NPI: 1467239327
Provider Name (Legal Business Name): NICOLE PARKER LCSW 127441
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 811
CLOVIS CA
93613-0811
US

IV. Provider business mailing address

2623 FINCHWOOD AVE
CLOVIS CA
93611-8575
US

V. Phone/Fax

Practice location:
  • Phone: 559-365-6603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number127441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: