Individual
NIDA KICHKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
510 S GRAND AVE STE 200, GLENDORA, CA 91741-4291
(626) 914-1980
Mailing address
1010 N AVENUE 66, LOS ANGELES, CA 90042-1512
(626) 374-9774
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95011993
CA
Other
Enumeration date
06/22/2019
Last updated
06/21/2021
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