Provider Demographics
NPI:1952495566
Name:PERLMAN, NICOLE A (MFT)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:A
Last Name:PERLMAN
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 1:8424 A SANTA MONICA BLVD. #239
Mailing Address - Street 2:
Mailing Address - City:W. HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069
Mailing Address - Country:US
Mailing Address - Phone:714-906-9630
Mailing Address - Fax:714-571-5659
Practice Address - Street 1:1200 N. MAIN ST., SUITE 100-B
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701
Practice Address - Country:US
Practice Address - Phone:714-480-4674
Practice Address - Fax:714-571-5659
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist