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Individual

NICOLE AVILA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A. ED

Contact information

Practice address
290 IOOF AVE, GILROY, CA 95020-5204
(408) 846-2100
Mailing address
290 IOOF AVE, GILROY, CA 95020-5204
(408) 846-2100

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6329
CA
101YM0800X
Mental Health Counselor
6329
CA
101YP2500X
Professional Counselor
Primary
6329
CA

Other

Enumeration date
01/12/2016
Last updated
05/01/2019
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