Provider Demographics
NPI:1407040751
Name:JONES-NICOL, DORIS (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:JONES-NICOL
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:7125 COZYCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3410
Mailing Address - Country:US
Mailing Address - Phone:818-883-9124
Mailing Address - Fax:818-883-3220
Practice Address - Street 1:3660 WILSHIRE BLVD
Practice Address - Street 2:907
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2719
Practice Address - Country:US
Practice Address - Phone:213-486-4270
Practice Address - Fax:213-739-1017
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP11925103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist