Provider Demographics
NPI:1134957988
Name:NICHOLSON, ALLAN JOSEPH (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:JOSEPH
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 557 BOX 2321
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379-0024
Mailing Address - Country:US
Mailing Address - Phone:530-863-6128
Mailing Address - Fax:
Practice Address - Street 1:PSC 557 BOX 2321
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96379-0024
Practice Address - Country:US
Practice Address - Phone:530-863-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810009115103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist