Individual
PAMELA NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
490 CHADBOURNE RD, SUITE A, FAIRFIELD, CA 94534-9613
(707) 422-0464
(707) 422-0465
Mailing address
PO BOX 304, FAIRFIELD, CA 94533-0030
(707) 422-0464
(707) 422-0465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
11/08/2010
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