Provider Demographics
NPI:1326170499
Name:VETTER, NICHOLAS JAMES (LMFT)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:JAMES
Last Name:VETTER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:NICK
Other - Middle Name:
Other - Last Name:VETTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:17508 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-2903
Mailing Address - Country:US
Mailing Address - Phone:818-838-0779
Mailing Address - Fax:818-886-5664
Practice Address - Street 1:11565 LAUREL CANYON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4649
Practice Address - Country:US
Practice Address - Phone:818-838-1352
Practice Address - Fax:818-838-1362
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist