MEDICARE: NICOLE B NICHOLAS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1851540397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE B NICHOLAS

Provider Business Mailing Address
First Line	:	2103 S EL CAMINO REAL STE 202
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6281
Country	:	US
Telephone Number	:	442-500-8548
Fax Number	:	760-400-8379

Provider Business Practice Location Address
First Line	:	2103 S EL CAMINO REAL STE 202
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6281
Country	:	US
Telephone Number	:	442-500-8548
Fax Number	:	760-400-8379

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

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	07/10/2025

Similar Medicare Providers

1245069616 — WILLOW TREE LICENSED CLINICAL SOCIAL WORKER
Practice Location Address:

2103 S EL CAMINO REAL STE 202
OCEANSIDE, CA
92054-6281

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1265694681 — MR. THOMAS PATRICK SCHMIERER LMFT
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1760639835 — AUDIE NELSON BRINKER
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1821577081 — MS. ELIZABETH KATHERINE WEISENBURGER MS, MA, CRC
Practice Location Address:

2103 S EL CAMINO REAL STE 206
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1275009615 — ELIZABETH HUA LPCC
Practice Location Address:

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1912542937 — QUALICARE (FAMILY HOMECARE) - NORTH SAN DIEGO COUNTY, INC.
Practice Location Address:

2103 S EL CAMINO REAL STE 204
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92054-6281

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Directions to “ NICOLE B NICHOLAS ” Practice Location

Language	Start Address	Practice Location

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