Organization
NICOLE LIGHTMAN, PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE LIGHTMAN PHD (PRESIDENT/ OWNER)
(520) 400-8171
Entity
Organization
Contact information
Practice address
3400 AVENUE OF THE ARTS APT A220, COSTA MESA, CA 92626-7116
(520) 400-8171
Mailing address
3400 AVENUE OF THE ARTS APT A220, COSTA MESA, CA 92626-7116
(520) 400-8171
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
02/25/2018
Last updated
02/25/2018
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