Basic Information
| Provider Information | |||||||||
| NPI: | 1750780060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BETTOSINI | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | GIORGIO | ||||||||
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| Credential: | MSW/ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14320 PALM DR | ||||||||
| Address2: | |||||||||
| City: | DESERT HOT SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922406874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607736767 | ||||||||
| FaxNumber: | 7607736760 | ||||||||
| Practice Location | |||||||||
| Address1: | 14320 PALM DR | ||||||||
| Address2: | |||||||||
| City: | DESERT HOT SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922406874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607736767 | ||||||||
| FaxNumber: | 7607736760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2014 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 1041C0700X | 84524 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.