Provider Demographics
NPI:1881467280
Name:FELIX, NICOLE (MSW ACSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FELIX
Suffix:
Gender:F
Credentials:MSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 MONTBATTEN PL
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6799
Mailing Address - Country:US
Mailing Address - Phone:559-916-7655
Mailing Address - Fax:
Practice Address - Street 1:3715 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-2719
Practice Address - Country:US
Practice Address - Phone:661-868-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118367104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty