Most Relevant Information
Provider Data
| NPI Number: | 1003431495 |
| Provider Name: | TRAVIS GEORGE NICHOLS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | R1370771119 |
Most Important Dates
| Enumeration Date: | 06/10/2020 |
| Last Updated: | 06/10/2020 |
Provider Practice Location
1914 22ND ST
SACRAMENTO
CA
958167109
Practice Location Phone/Fax
| Phone: | 9164556258 |
| Fax: |
Provider Mailing Location
1914 22ND ST
SACRAMENTO
CA
958167109
Provider Mailing Phone/Fax
| Phone: | 9164556258 |
| Fax: |