Most Relevant Information
Provider Data
| NPI Number: | 1003196403 |
| Provider Name: | NICOLE TAKLA PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | PSY26532 |
Most Important Dates
| Enumeration Date: | 08/17/2011 |
| Last Updated: | 09/30/2014 |
Provider Practice Location
7707 AUSTIN RD
STOCKTON
CA
952158312
Practice Location Phone/Fax
| Phone: | 2094674398 |
| Fax: |
Provider Mailing Location
5424 SUNOL BLVD
SUITE 10-120
PLEASANTON
CA
945667705
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |