Nicholson, Lisa

Nicholson, Lisa is an individual health care provider with primary practice located at 200 Medical Plaza Suite 265 , Los Angeles CA 90095. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Nicholson, Lisa can be contacted via phone (310) 794-5066.

Contact Information

Primary practice address
200 Medical Plaza Suite 265 Los Angeles CA 90095
Phone: (310) 794-5066
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 17370 California

Profile Details

NPI number 1295934479
LBN Legal business name Nicholson, Lisa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Jun 1st, 2018 - about 7 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 1295934479 NPPES
California Other 409782 CALIFORNIA BOARD OF REGIS

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