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General NPI Number Information
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NPI Number | 1255292025
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Entity Type | Organization
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Legal Business Name | THALIA NICHOLSON PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1700 EUREKA RD STE 155
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City | ROSEVILLE
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State | CA
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Zip | 95661-7786
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Country | US
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Telephone | 530-423-3714
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Fax |
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Provider Business Mailing Address
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Address Line | 140 PINE ST
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City | AUBURN
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State | CA
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Zip | 95603-5247
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | THALIA PITSILLIDOU SULLIVAN NICHOLSON
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Credential | PHD
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Telephone | 530-423-3714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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