Provider Demographics
NPI:1003050329
Name:NICHOLS, JOI NOREEN
Entity Type:Individual
Prefix:MRS
First Name:JOI
Middle Name:NOREEN
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 W. EXPOSITION BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016
Mailing Address - Country:US
Mailing Address - Phone:213-342-3114
Mailing Address - Fax:323-296-3049
Practice Address - Street 1:9150 EAST IMPERIAL HIGHWAY , ROOM P-31
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242
Practice Address - Country:US
Practice Address - Phone:562-940-3694
Practice Address - Fax:562-658-7425
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
171M00000XOtherCASE MANAGER/CARE COORDINATOR