Individual
MICHAEL KIAMOS NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, MSN, PMHNP-BC
Contact information
Practice address
3075 ADELINE ST., #280, BERKELEY, CA 94703
(510) 981-4100
Mailing address
3075 ADELINE ST STE 280, BERKELEY, CA 94703-2580
(510) 981-4100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95019631
CA
Other
Enumeration date
06/06/2022
Last updated
12/09/2022
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