Joanna Camille Nicholson, PA-C
Physician Assistant, Surgical in San Diego, CA. Individual provider (NPI-1).
NPI number1982833232
StatusActive
Last updated in NPPESDec 23, 2011
Details
- NPI
- 1982833232
- Entity type
- Individual (NPI-1)
- Name
- Joanna Camille Nicholson
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2009
- Last updated
- Dec 23, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 16008 | CA | Yes |
Practice location
9339 Genesee AvePlaza 39
San Diego, CA 92121-2119
Phone 858-455-7557 · Fax 858-455-1287
Mailing address
Po Box 12060Las Vegas, NV 89112-0060
Phone 702-360-2100 · Fax 909-557-1924
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