Provider Demographics
NPI:1912769779
Name:ADAMS, NIKO IOSEFO
Entity Type:Individual
Prefix:
First Name:NIKO
Middle Name:IOSEFO
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11140 LOS ALAMITOS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3622
Mailing Address - Country:US
Mailing Address - Phone:310-406-1500
Mailing Address - Fax:310-406-1531
Practice Address - Street 1:3491 ELM AVE # NA
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4430
Practice Address - Country:US
Practice Address - Phone:310-406-1500
Practice Address - Fax:310-406-1531
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician