Individual
CHANDRA ELOIS NICKERBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 W TEMPLE ST, LOS ANGELES, CA 90026-4915
(213) 304-1449
Mailing address
2121 W TEMPLE ST, LOS ANGELES, CA 90026-4915
(213) 304-1449
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
05/02/2025
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