Provider Demographics
NPI:1033557707
Name:CORDOVA, NICHOLAS A (LMFT)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:A
Last Name:CORDOVA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DECLARATION DR STE E
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4931
Mailing Address - Country:US
Mailing Address - Phone:530-685-8885
Mailing Address - Fax:
Practice Address - Street 1:10 DECLARATION DR STE E
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4931
Practice Address - Country:US
Practice Address - Phone:530-685-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA104728106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health