MEDICARE: MISS NICOLE ERIN PIQUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	9627	TX
2	103K00000X	Behavior Analyst	25-0940-593100	CA

General Provider Information

NPI Number	:	1306438403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NICOLE ERIN PIQUE

Provider Business Mailing Address
First Line	:	2758 ARIANE DR UNIT 126
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3412
Country	:	US
Telephone Number	:	214-797-7559
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 MIDWAY DR
Second Line	:	UNIT 371141
City	:	SAN DIEGO
State	:	CA
Zip	:	92110
Country	:	US
Telephone Number	:	904-638-6388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	05/25/2026

Similar Medicare Providers

1144151713 — AUGUSTINE MAKUOCHUKWU ODOZOR RN
Practice Location Address:

3853 ROSECRANS ST
SAN DIEGO, CA
92110-3115

Practice Phone: 619-692-8232
Practice Fax: 619-542-4060

1275112955 — CHRISTIAN PALIANGAYAN
Practice Location Address:

3491 KURTZ ST STE 150
SAN DIEGO, CA
92110-4430

Practice Phone: 619-332-5830
Practice Fax: 619-810-2313

1902737224 — RHIANNON RATH
Practice Location Address:

3132 JEFFERSON ST
SAN DIEGO, CA
92110-4421

Practice Phone: 619-683-3100
Practice Fax:

1932030269 — JORGE MARIO MARTINEZ
Practice Location Address:

3132 JEFFERSON ST
SAN DIEGO, CA
92110-4421

Practice Phone: 619-683-3100
Practice Fax:

1700758752 — WHITNEY HALLECK
Practice Location Address:

1260 MORENA BLVD STE 100
SAN DIEGO, CA
92110-3850

Practice Phone: 619-398-0355
Practice Fax:

1952724817 — PACIFIC NEUROBEHAVIORAL CLINIC: A PSYCHOLOGICAL CORPORATION
Practice Location Address:

3990 OLD TOWN AVE STE C303
SAN DIEGO, CA
92110-2932

Practice Phone: 858-964-0722
Practice Fax: 866-437-0375

Directions to “ MISS NICOLE ERIN PIQUE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.