Individual
MARY CELESTE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4805 WESTMONT AVE, CAMPBELL, CA 95008-5725
(408) 549-4673
Mailing address
4805 WESTMONT AVE, CAMPBELL, CA 95008-5725
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
240139284
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/29/2019
Last updated
08/08/2025
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