Healthcare Provider Details

I. General information

NPI: 1225236219
Provider Name (Legal Business Name): NICOLE E. MEVS-MARTIN MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31165 TEMECULA PKWY STE 1027
TEMECULA CA
92592-2908
US

IV. Provider business mailing address

5677 S TRANSIT RD STE 318
LOCKPORT NY
14094-5842
US

V. Phone/Fax

Practice location:
  • Phone: 951-541-2031
  • Fax:
Mailing address:
  • Phone: 951-541-2031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF001740
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 79622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: