Doctor Name: | MRS. CARRIE BEINER NICHOLS |
NPI Number: | 1497817506 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW INTERN |
License Number: | |
Business Practice Address: | 240 S Hickory St # 210 Escondido, CA - 920254355 |
Business Phone Number: | 7607470205 |
Business Fax Number: | 7607470582 |
Mailing Address: | 2380 Hosp Way Apt 237, CARLSBAD |
State: | CA |
Postal Code: | 920081232 |
Phone Number: | 7602143866 |
Fax Number: | |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |