Individual
NICOLE MARIE TIA BARCEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
435 H ST, CV112, CHULA VISTA, CA 91910
(619) 691-7587
Mailing address
435 H ST, CV112, CHULA VISTA, CA 91910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A21788
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
20A21788
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2022
Last updated
10/19/2025
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