Individual provider · Type 1 NPI

Pamela Nicholson

Developmental Therapist · Fairfield, CA

NPI number 1639376940 Active

Practice location

490 Chadbourne Rd, Suite A
Fairfield, CA 94534-9613

Call (707) 422-0464 Map

Fax (707) 422-0465

Mailing address

PO Box 304
Fairfield, CA 94533-0030

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1639376940

Pamela Nicholson's National Provider Identifier is 1639376940, issued on Jun 29, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Fairfield, CA. The record was last updated on Nov 8, 2010.