Individual
DR. ELLEN ELIZABETH NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
360 MOBIL AVE STE K, CAMARILLO, CA 93010-6325
(818) 584-4728
(818) 706-8684
Mailing address
1860 FALLING STAR AVE, WESTLAKE VILLAGE, CA 91362-5277
(818) 522-3810
(818) 706-8684
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94022807
CA
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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