Individual
KATRINA SAN NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1963 4TH AVE, SAN DIEGO, CA 92101-2394
(619) 233-3432
(619) 233-7022
Mailing address
1963 4TH AVE, SAN DIEGO, CA 92101-2394
(619) 233-3432
(619) 233-7022
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/14/2007
Last updated
12/14/2007
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