Provider Demographics
NPI:1760714919
Name:POWERS, NICHOLAS AARON
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:AARON
Last Name:POWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 MYERS ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5527
Mailing Address - Country:US
Mailing Address - Phone:951-358-6858
Mailing Address - Fax:951-358-6865
Practice Address - Street 1:30755 AULD RD STE C
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2581
Practice Address - Country:US
Practice Address - Phone:951-600-6800
Practice Address - Fax:951-600-6805
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist