| Doctor Name: | NICHOLE JIMMI |
| NPI Number: | 1922476886 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 95061156 |
| Business Practice Address: | 1670 Kettner Blvd Apt 122 San Diego, CA - 921012522 |
| Business Phone Number: | 5616744994 |
| Business Fax Number: | |
| Mailing Address: | 1670 Kettner Blvd, Apt 122 SAN DIEGO |
| State: | CA |
| Postal Code: | 921012522 |
| Phone Number: | 5616744994 |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2015 |
| NPI Last Update Date: | 09/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283Q00000X |
| License Number: | 95061156 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Psychiatric Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |