Provider Demographics
NPI:1356909675
Name:NICKEL, CHRISTA RUTH (AUD)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:RUTH
Last Name:NICKEL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14637 MAGNOLIA BLVD APT 6
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1481
Mailing Address - Country:US
Mailing Address - Phone:308-850-5331
Mailing Address - Fax:
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:ST. #103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3045
Practice Address - Country:US
Practice Address - Phone:626-631-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-01
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist