Healthcare Provider Details

I. General information

NPI: 1962835652
Provider Name (Legal Business Name): NICOLE DEBORAH NEHORAOFF LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 LEEDS ST
DOWNEY CA
90242-3489
US

IV. Provider business mailing address

838 N DOHENY DR APT 1106
WEST HOLLYWOOD CA
90069-4851
US

V. Phone/Fax

Practice location:
  • Phone: 858-336-3081
  • Fax:
Mailing address:
  • Phone: 858-336-3081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: