Provider Demographics
NPI:1023807823
Name:UMANA, NICHOLAS REYNOLDS
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:REYNOLDS
Last Name:UMANA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 G ST APT B
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6378
Mailing Address - Country:US
Mailing Address - Phone:951-403-2218
Mailing Address - Fax:
Practice Address - Street 1:635 G ST APT B
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6378
Practice Address - Country:US
Practice Address - Phone:951-403-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health