Individual
DR. NICOLE POLIQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1800 FAIRBURN AVE, SUITE #105, LOS ANGELES, CA 90025-5958
(310) 474-8388
Mailing address
1800 FAIRBURN AVE, SUITE #105, LOS ANGELES, CA 90025-5958
(310) 474-8388
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A30419
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A30419
CA
Other
Enumeration date
10/09/2006
Last updated
09/11/2025
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