Provider Demographics
NPI:1134625288
Name:BETCHEL, NICHOLAS TIM (DO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:TIM
Last Name:BETCHEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2210 E ILLINOIS AVE STE 401
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2184
Practice Address - Country:US
Practice Address - Phone:559-320-0580
Practice Address - Fax:559-320-0582
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A177992084P0800X
CA177992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry