Provider Demographics
NPI:1275315145
Name:DORHAN, NICOLE J (REGISTERED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:J
Last Name:DORHAN
Suffix:
Gender:F
Credentials:REGISTERED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 SMITH RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2093
Mailing Address - Country:US
Mailing Address - Phone:415-492-0818
Mailing Address - Fax:
Practice Address - Street 1:2010 SHADY LN
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2120
Practice Address - Country:US
Practice Address - Phone:415-306-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)