Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 378000 | CA |
NPI | 1033225057 |
---|---|
Provider Name | Ms. Natalya Nicoloff |
First Address | Union City, CA 94587-1507 |
Second Address | Union City, CA 94587-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 30/06/2015 |