Individual
MS. MYRIAME MIA NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
158 C AVE, CORONADO, CA 92118-1420
(619) 435-5400
Mailing address
158 C AVE, CORONADO, CA 92118-1420
(619) 435-5400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95024480
CA
Other
Enumeration date
06/05/2023
Last updated
04/19/2026
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