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General NPI Number Information
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NPI Number | 1790157576
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Entity Type | Individual
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Provider Name | NIKKI THOMAS-RHODEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1850 SAWTELLE BLVD STE 490
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City | LOS ANGELES
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State | CA
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Zip | 90025-7028
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Country | US
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Telephone | 818-519-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 578 WASHINGTON BLVD # 815
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5442
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Country | US
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Telephone | 818-519-7155
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117113
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License Number State | CA
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