Individual
NICOLE INDART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3717 MT DIABLO BLVD, SUITE 100, LAFAYETTE, CA 94549-3588
(925) 284-5300
(925) 284-5381
Mailing address
3717 MT DIABLO BLVD, SUITE 100, LAFAYETTE, CA 94549-3588
(925) 284-5300
(925) 284-5381
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT24274
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT24274
PT LICENSE
CA
Enumeration date
01/05/2016
Last updated
02/11/2025
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