Basic Information
| Provider Information | |||||||||
| NPI: | 1952514531 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REIMERS | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3461 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959273461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308162545 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 88 TABLE MOUNTAIN BLVD | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959653578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305382158 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 08/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC 46512 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.