Individual
NICHOLE THERESA GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58923 BUSINESS CENTER DR STE E, YUCCA VALLEY, CA 92284-7311
(760) 848-8480
Mailing address
58923 BUSINESS CENTER DR STE E, YUCCA VALLEY, CA 92284-7311
(760) 848-8480
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
08/12/2021
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