Individual
MICHELLE KAYE F NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
45 CASTRO ST, SAN FRANCISCO, CA 94114-1010
(415) 600-6130
Mailing address
816 LINDA MAR BLVD, PACIFICA, CA 94044-3449
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
05555
MD
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
9820
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9820
OTR/L
CA
Enumeration date
06/25/2009
Last updated
01/11/2022
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