Provider Demographics
NPI:1588743066
Name:DORSEY, NIKKI SHEREE
Entity type:Individual
Prefix:MISS
First Name:NIKKI
Middle Name:SHEREE
Last Name:DORSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 DALY ST.
Mailing Address - Street 2:2ND FL.
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-3309
Mailing Address - Country:US
Mailing Address - Phone:323-226-4459
Mailing Address - Fax:323-223-8380
Practice Address - Street 1:1925 DALY ST
Practice Address - Street 2:2ND FL
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3309
Practice Address - Country:US
Practice Address - Phone:323-226-4459
Practice Address - Fax:323-223-8380
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS22665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health