Individual
ANGIE JO NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4545 GEORGETOWN PL, B-13, STOCKTON, CA 95207-6215
(209) 224-4994
Mailing address
4908 COZAD WAY, STOCKTON, CA 95212-1904
(209) 244-4994
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
52080
CA
Other
Enumeration date
03/02/2009
Last updated
11/02/2015
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