Healthcare Provider Details

I. General information

NPI: 1962358614
Provider Name (Legal Business Name): NICOLE WELSH NUTRITION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 MERRIMAC RD
LOS ANGELES CA
90049-1034
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD # 759523
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 310-717-9300
  • Fax:
Mailing address:
  • Phone: 310-717-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLE TOPPINO WELSH
Title or Position: NUTRITIONIST
Credential: MS
Phone: 310-717-9300