Provider Demographics
NPI:1760854707
Name:PALMER, NICOLA JAYNE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:JAYNE
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13112 HADLEY ST STE 107
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4583
Mailing Address - Country:US
Mailing Address - Phone:562-298-0603
Mailing Address - Fax:562-789-4273
Practice Address - Street 1:13112 HADLEY ST STE 107
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4583
Practice Address - Country:US
Practice Address - Phone:562-298-0603
Practice Address - Fax:562-789-4273
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist