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General NPI Number Information
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NPI Number | 1710866041
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Entity Type | Individual
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Provider Name | NICOLE GAMBLE
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Gender | Female
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 633 W 5TH ST STE 2613
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City | LOS ANGELES
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State | CA
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Zip | 90071-2005
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Country | US
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Telephone | 213-683-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 295 89TH ST STE 306
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City | DALY CITY
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State | CA
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Zip | 94015-1656
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Country | US
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Telephone | 87-726-4674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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