Provider Demographics
NPI:1659707446
Name:NULLMEYER, JODIE NICOLE
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:NICOLE
Last Name:NULLMEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-5646
Mailing Address - Country:US
Mailing Address - Phone:209-662-1633
Mailing Address - Fax:
Practice Address - Street 1:697 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5646
Practice Address - Country:US
Practice Address - Phone:209-662-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor