Provider Demographics
NPI:1972143949
Name:HREBIEN, NICHOLAS DANIEL
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DANIEL
Last Name:HREBIEN
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 1:14059 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2657
Mailing Address - Country:US
Mailing Address - Phone:562-309-3501
Mailing Address - Fax:
Practice Address - Street 1:10155 COLIMA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2042
Practice Address - Country:US
Practice Address - Phone:562-692-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CAAMFT109458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst