MEDICARE: DR. NICOLLE S WALTERS PHD

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	103TC0700X	Clinical Psychologist	PSY15949	CA

General Provider Information

NPI Number	:	1881752558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLLE S WALTERS PHD

Provider Business Mailing Address
First Line	:	77564 COUNTRY CLUB DR
Second Line	:	SUITE 408
City	:	PALM DESERT
State	:	CA
Zip	:	92211-0484
Country	:	US
Telephone Number	:	760-898-2968
Fax Number	:	760-345-3888

Provider Business Practice Location Address
First Line	:	77564 COUNTRY CLUB DR
Second Line	:	SUITE 408
City	:	PALM DESERT
State	:	CA
Zip	:	92211-0484
Country	:	US
Telephone Number	:	760-898-2968
Fax Number	:	760-345-3888

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	01/15/2015

Similar Medicare Providers

1336679760 — MRS. KRYSTINA MAE MANIU MS
Practice Location Address:

77564 COUNTRY CLUB DR # A201
PALM DESERT, CA
92211-0484

Practice Phone: 760-702-0095
Practice Fax:

1598706111 — EVELYN MARTHA EASTMAN M.A.
Practice Location Address:

77564 COUNTRY CLUB DR
PALM DESERT, CA
92211-0484

Practice Phone: 760-831-0610
Practice Fax: 760-772-4264

1942225917 — WENDY LYNNE BAKER LMFT
Practice Location Address:

77564 COUNTRY CLUB DR , BLDG. A, STE. 214
PALM DESERT, CA
92211-0484

Practice Phone: 760-668-0906
Practice Fax: 760-360-9851

1033205026 — DR. KOUROSH DIANATYAZDI DDS
Practice Location Address:

77564 COUNTRY CLUB DR , SUITE 350
PALM DESERT, CA
92211-0484

Practice Phone: 760-772-7082
Practice Fax: 760-772-7085

1669555124 — DR. ROSALIND MAXINE MONAHAN PHD., LCSW
Practice Location Address:

77564 COUNTRY CLUB DR # B , STE. 405-B
PALM DESERT, CA
92211-0484

Practice Phone: 760-776-2525
Practice Fax:

1669545752 — DR. GARY U OKAMOTO D.M.D.
Practice Location Address:

77564 COUNTRY CLUB DR , #190A
PALM DESERT, CA
92211-0484

Practice Phone: 760-360-0622
Practice Fax: 760-360-6282

Directions to “ DR. NICOLLE S WALTERS PHD” 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.