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General NPI Number Information
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NPI Number | 1548958515
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Entity Type | Organization
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Legal Business Name | NIXON PSYCHOLOGICAL INSTITUTE, INC.
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 12530 10TH ST STE C
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City | CHINO
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State | CA
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Zip | 91710-3520
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Country | US
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Telephone | 949-478-1878
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Fax |
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Provider Business Mailing Address
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Address Line | 27 KNOLLVIEW DR
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City | POMONA
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State | CA
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Zip | 91766-4928
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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 | PRESIDENT
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Name | DR. KYLE HOLLIS NIXON
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Credential | PHD
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Telephone | 949-478-1878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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