Individual
FAITH N NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58471 29 PALMS HWY STE 102, YUCCA VALLEY, CA 92284-5818
(760) 853-4888
Mailing address
58471 29 PALMS HWY STE 102, YUCCA VALLEY, CA 92284-5818
(857) 760-4888
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
MPSS-OVWSLE
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/16/2022
Last updated
05/30/2024
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