Nickerson, Molly Beth

Nickerson, Molly Beth is an sole proprietor health care provider with primary practice located at 923 S Catalina Ave , Redondo Beach CA 90277-4718. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, which is considered as her primary health care specialty. Nickerson, Molly Beth can be contacted via phone (310) 792-5454.

Contact Information

Primary practice address
923 S Catalina Ave Redondo Beach CA 90277-4718
Phone: (310) 792-5454
Fax: (310) 792-5463
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X

Profile Details

NPI number 1053560573
LBN Legal business name Nickerson, Molly Beth
Credentials MSW, ACSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2008
Last updated Jan 19th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053560573 NPPES
California MEDICAID 1053560573

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