Provider Demographics
NPI:1063201051
Name:WARD, NICHOLAS GENE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:GENE
Last Name:WARD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 CITRUS CIR STE 240
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2691
Mailing Address - Country:US
Mailing Address - Phone:925-237-1830
Mailing Address - Fax:
Practice Address - Street 1:3021 CITRUS CIR STE 240
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2691
Practice Address - Country:US
Practice Address - Phone:925-237-1830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY36298103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical