Provider Demographics
NPI:1114715893
Name:NICHOLS, DORSHA (DC)
Entity type:Individual
Prefix:DR
First Name:DORSHA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 S ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-6760
Mailing Address - Country:US
Mailing Address - Phone:510-421-7696
Mailing Address - Fax:
Practice Address - Street 1:1909 CAPITOL AVE STE 203
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-4242
Practice Address - Country:US
Practice Address - Phone:510-421-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor