Provider Demographics
NPI:1154296374
Name:NICOLES ELECTROLYSIS, INC.
Entity type:Organization
Organization Name:NICOLES ELECTROLYSIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LE
Authorized Official - Phone:209-294-0634
Mailing Address - Street 1:1517 G ST APT I
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1649
Mailing Address - Country:US
Mailing Address - Phone:209-294-0634
Mailing Address - Fax:916-246-6422
Practice Address - Street 1:1675 ALHAMBRA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7178
Practice Address - Country:US
Practice Address - Phone:209-294-0634
Practice Address - Fax:916-246-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty