Individual
DEVON NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
773 WILLBOROUGH RD, BURLINGAME, CA 94010-3718
(650) 773-0708
Mailing address
773 WILLBOROUGH RD, BURLINGAME, CA 94010-3718
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11037982
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95034249
CA
Other
Enumeration date
02/28/2025
Last updated
03/05/2025
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