Dr. Nichole Lynn Mogharreban
Psychologist Clinical Psychologist
9040 Jackson Ave Madigan Army Medical Center
Tacoma
, Washington 98431-0001
Dr. Nichole Lynn Mogharreban
Psychologist Clinical Psychologist
9040 Jackson Ave Madigan Army Medical Center
Tacoma
, Washington 98431-0001
(650) 723-4000
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Nichole Lynn Mogharreban
- 300 Pasteur Dr
- Stanford, CA
- Zip : 94305-2200
- Phone : (650) 723-4000
Second Address
- Dr. Nichole Lynn Mogharreban
- 9040 Jackson Ave Madigan Army Medical Center
- Tacoma, WA
- Zip : 98431-0001
- Phone : (253) 968-2252
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | 30199 | CA |
| N | 103T00000X | Psychologist | 30199 | CA |
| Y | 103G00000X | Clinical Psychologist | PY60446879 | WA |
| Y | 103TC0700X | Clinical Psychologist | PY60446879 | WA |
National Provider Identifier
| NPI | 1013270180 |
|---|---|
| Provider Name | Dr. Nichole Lynn Mogharreban |
| First Address | Stanford, CA 94305-2200 |
| Second Address | Tacoma, WA 98431-0001 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2012 |
| Last Update Date | 18/12/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.