Healthcare Provider Details

I. General information

NPI: 1588811889
Provider Name (Legal Business Name): NICOLE RYMER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E TULARE AVE
VISALIA CA
93292-3629
US

IV. Provider business mailing address

5957 S MOONEY BLVD
VISALIA CA
93277-9394
US

V. Phone/Fax

Practice location:
  • Phone: 559-623-0999
  • Fax: 559-730-9937
Mailing address:
  • Phone: 559-737-4660
  • Fax: 559-737-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: