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Individual

MS. DONNA MARIE NICHOLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1980 ALLSTON WAY # H105, BERKELEY, CA 94704-1463
(510) 644-6965
(510) 644-2887
Mailing address
915 ESTUDILLO AVE, SAN LEANDRO, CA 94577-5101
(510) 861-3993

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
437377
CA

Other

Enumeration date
07/09/2018
Last updated
07/09/2018
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