Provider Demographics
NPI:1750902466
Name:CHAPLIN, NIKOLAS ANDRAE
Entity type:Individual
Prefix:
First Name:NIKOLAS
Middle Name:ANDRAE
Last Name:CHAPLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 BRICKYARD COVE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-4112
Mailing Address - Country:US
Mailing Address - Phone:510-609-5056
Mailing Address - Fax:
Practice Address - Street 1:1160 BRICKYARD COVE RD STE 111
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-4112
Practice Address - Country:US
Practice Address - Phone:510-609-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health