Provider Demographics
NPI:1821157652
Name:TIGHE, NIKKI G (MFT)
Entity Type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:G
Last Name:TIGHE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 W AVENUE J
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2827
Mailing Address - Country:US
Mailing Address - Phone:661-948-2810
Mailing Address - Fax:661-729-2525
Practice Address - Street 1:1672 W AVENUE J
Practice Address - Street 2:SUITE 207
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2827
Practice Address - Country:US
Practice Address - Phone:661-948-2810
Practice Address - Fax:661-729-2525
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40244106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist