| Lynn L Nickens, M.s.w., Lcsw | |
|
14240 Saint Andrews Dr Suite 101 Victorville CA 92395-4308 | |
| (760) 927-8896 | |
| (866) 382-9020 |
| Full Name | Lynn L Nickens, M.s.w., Lcsw |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14240 Saint Andrews Dr, Victorville, California |
| Authorized Official Name and Position | Lynn Nickens (PRESIDENT) |
| Authorized Official Contact | 7609278896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn L Nickens, M.s.w., Lcsw 1554 Barton Rd # 114 Redlands CA 92373-5457 Ph: (760) 927-8896 | Lynn L Nickens, M.s.w., Lcsw 14240 Saint Andrews Dr Suite 101 Victorville CA 92395-4308 Ph: (760) 927-8896 |
| NPI Number | 1457626889 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 03/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457626889 | NPI | - | NPPES |
| 1114138252 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 18158 (California) | Primary |
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