Mcnicholas, Mary C

Mcnicholas, Mary C is an individual health care provider with primary practice located at 2100 Powell St Suite 920, Emeryville CA 94608-1826. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mcnicholas, Mary C can be contacted via phone (510) 350-2655.

Contact Information

Primary practice address
2100 Powell St Suite 920 Emeryville CA 94608-1826
Phone: (510) 350-2655
Fax: (510) 879-9071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA14376 California

Profile Details

NPI number 1295791960
LBN Legal business name Mcnicholas, Mary C
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Dec 16th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295791960 NPPES
California MEDICAID PA14376

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