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General NPI Number Information
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NPI Number | 1861878647
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Entity Type | Individual
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Provider Name | NICHOLE CECIL PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 9200 OAKDALE AVE STE 100
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City | CHATSWORTH
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State | CA
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Zip | 91311-6505
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Country | US
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Telephone | 818-778-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 OAKDALE AVE STE 100
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City | CHATSWORTH
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State | CA
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Zip | 91311-6505
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Country | US
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Telephone | 818-778-1900
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35474
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 35474
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License Number State | CA
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