Individual
JASON NIKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1950 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1222
(650) 573-3571
Mailing address
1950 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1222
(650) 573-3571
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A74019
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A740190
—
CA
Enumeration date
01/23/2007
Last updated
01/15/2021
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