Individual provider · Type 1 NPI

Timothy Mark Nickell, MHRS

Mental Health Counselor · San Leandro, CA

NPI number 1710050752 Active

Practice location

2275 Arlington Dr
San Leandro, CA 94578-1132

Mailing address

770 Kingston Ave, Apt 201
Piedmont, CA 94611-4457

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1710050752

Timothy Mark Nickell, MHRS's National Provider Identifier is 1710050752, issued on Nov 16, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Leandro, CA. The record was last updated on Jul 8, 2007.