Provider Demographics
NPI:1235207739
Name:NICHOLS, AVANI PATEL (DC)
Entity Type:Individual
Prefix:DR
First Name:AVANI
Middle Name:PATEL
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AVANI
Other - Middle Name:THAKOR
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 3444
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92605-3444
Mailing Address - Country:US
Mailing Address - Phone:714-742-8168
Mailing Address - Fax:
Practice Address - Street 1:8191 FRIESLAND DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6301
Practice Address - Country:US
Practice Address - Phone:714-742-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor