Provider Demographics
NPI:1255588919
Name:HOUGHT, NICOLE ROXANNE
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ROXANNE
Last Name:HOUGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:ROXANNE
Other - Last Name:DOLZADELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4716
Mailing Address - Country:US
Mailing Address - Phone:707-318-9425
Mailing Address - Fax:
Practice Address - Street 1:2300 NORTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407
Practice Address - Country:US
Practice Address - Phone:707-571-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator