| Doctor Name: | DR. JOSEPH REESE NICOLINI |
| NPI Number: | 1013915628 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O., PH.D. |
| License Number: | 071-005945 |
| Business Practice Address: | 2500 East Main Street Christus Spohn Hospital Alice, TX - 78332 |
| Business Phone Number: | 3616618000 |
| Business Fax Number: | |
| Mailing Address: | 402 W Broadway, Fourth Floor SAN DIEGO |
| State: | CA |
| Postal Code: | 921013542 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/08/2005 |
| NPI Last Update Date: | 02/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071-005945 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |