Individual
NICOLE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1012 W 11TH ST, UPLAND, CA 91786-3704
(909) 244-6177
Mailing address
1012 W 11TH ST, UPLAND, CA 91786-3704
(909) 244-6177
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025007741
CA
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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