Provider Demographics
NPI:1013374032
Name:HANK TAPP, NICOLE (MS)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HANK TAPP
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:TAPP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14515 HAMLIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1608
Mailing Address - Country:US
Mailing Address - Phone:818-989-7475
Mailing Address - Fax:818-908-2434
Practice Address - Street 1:14515 HAMLIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411
Practice Address - Country:US
Practice Address - Phone:818-989-7475
Practice Address - Fax:818-908-2434
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC4905101YP2500X
CALPCC8955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional