=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205845773
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE METSCHER MFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2006
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9712 FAIR OAKS BLVD STE A2
-----------------------------------------------------
City | FAIR OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95628-7099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-759-1057
-----------------------------------------------------
Fax | 888-485-3327
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9712 FAIR OAKS BLVD STE A2
-----------------------------------------------------
City | FAIR OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95628-7099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-759-1057
-----------------------------------------------------
Fax | 888-485-3327
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC 43139
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY26636
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------