Doctor Name: | LESLEY D NICHOLSON |
NPI Number: | 1801169875 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT38761 |
Business Practice Address: | 9827 Walker St Cypress, CA - 906303826 |
Business Phone Number: | 7142209001 |
Business Fax Number: | 7142209006 |
Mailing Address: | 9827 Walker St, CYPRESS |
State: | CA |
Postal Code: | 906303826 |
Phone Number: | 7142209001 |
Fax Number: | 7142209006 |
NPI Enumeration Date: | 02/21/2012 |
NPI Last Update Date: | 12/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PT38761 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |