Provider Demographics
NPI:1528580230
Name:NICHOLS, JOSEPH F (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 VIA DE LA VALLE STE 205
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-4250
Mailing Address - Country:US
Mailing Address - Phone:858-350-6500
Mailing Address - Fax:858-350-6505
Practice Address - Street 1:3790 VIA DE LA VALLE STE 205
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4250
Practice Address - Country:US
Practice Address - Phone:858-350-6500
Practice Address - Fax:858-350-6505
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist