Provider Demographics
NPI:1780446971
Name:NIMMERS, TERRI A (MS)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:A
Last Name:NIMMERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:A
Other - Last Name:DOBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2033 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-3763
Mailing Address - Country:US
Mailing Address - Phone:310-386-1184
Mailing Address - Fax:
Practice Address - Street 1:4221 WILSHIRE BLVD STE 230
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3554
Practice Address - Country:US
Practice Address - Phone:213-505-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12379101YM0800X
CA135469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health