# NICOLE LIGHTMAN, PHD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811498827
- **Authorized official:** DR. NICOLE LIGHTMAN PHD (PRESIDENT/ OWNER)
- **Authorized official phone:** (520) 400-8171

## Contact information

- **Practice address:** 3400 AVENUE OF THE ARTS APT A220, COSTA MESA, CA 92626-7116
- **Practice address phone:** (520) 400-8171
- **Mailing address:** 3400 AVENUE OF THE ARTS APT A220, COSTA MESA, CA 92626-7116
- **Mailing address phone:** (520) 400-8171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 02/25/2018
- **Last updated:** 02/25/2018