Provider Demographics
NPI:1649697152
Name:FLOYD, NICOLE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 WARNER AVE APT B32
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4728
Mailing Address - Country:US
Mailing Address - Phone:267-475-8240
Mailing Address - Fax:
Practice Address - Street 1:17 IMA LOA CT
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2351
Practice Address - Country:US
Practice Address - Phone:267-475-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-15667103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst