Nichole M Mull
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Frenos, CA
NPI 1477022176 · NPPES record last updated Sep 11, 2020
Key facts
- NPI
- 1477022176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 2772 Martin Luther King Jr Blvd
Frenos, CA 93706 - Phone
- (559) 385-0053
- NPI assigned
- Nov 26, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
2772 Martin Luther King Jr Blvd
Frenos, CA 93706
Mailing address
2772 Martin Luther King Jr Blvd
Fresno, CA 93706
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.