Individual ProviderNichole Kathleen PalmerMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3273 Airway Dr Ste D, Santa Rosa, CA 95403-2080(650) 207-4767PECOS EnrollmentBased on the most recent information from CMS, provider Nichole Kathleen Palmer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336634419Provider TypeIndividualFull NamePalmer, Nichole KathleenGenderFemaleSole ProprietorNoEnumeration Date6/29/2018Last Updated8/14/2023Contact InformationPractice LocationPractice Address3273 Airway Dr Ste D, Santa Rosa, CA 95403-2080Phone(650) 207-4767FaxUnlisted FaxMailing LocationMailing Address8304 Windmill Farms Dr, Cotati, CA 94931-4569Phone(650) 207-4767FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense138589CaliforniaCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-18-58749California