Nicole Poliquin, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A30419 Issued in CA

Practice address

1800 Fairburn Ave
Suite #105
Los Angeles, CA 90025-5958

Phone

(310) 474-8388

NPI assigned

Oct 9, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: nicole.poliquin@bhsahc.eclinicaldirectplus.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1548357692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FAIRBURN AVE",
            "address_2": "SUITE #105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255958",
            "telephone_number": "310-474-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FAIRBURN AVE",
            "address_2": "SUITE #105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255958",
            "telephone_number": "310-474-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIQUIN",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A30419",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A30419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Poliboy, M.D.
• Laura Policarpo Hernandez, MSW, ACSW
• Polido Professional Dental Corporation
• Jose Carlos Daudt Polido, DDS
• Kristel Rei M Polintan
• Seth Politano, D.O.
• Delores Genise Polite
• Dorothy M. Polite
• Iia Poliuliak
• Alicea Polk

• Child & Adolescent Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.