Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICOLE MATEO LICUP NAM, NP
ActiveNICOLE MATEO LICUP NAM, NP is a Primary Care Nurse Practitioner healthcare provider located in LOS ANGELES, California. NPI 1538827985 is currently active in the NPPES registry. Verify at CMS.
Primary Care Nurse Practitioner · LOS ANGELES, CA
Registration Details
- NPI Number
- 1538827985
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 2, 2021 (4.7037148795881 yrs)
- Last Updated
- Feb 8, 2022
- Licenses
-
95085049 (CA)95015421 (CA)
Practice Information
- Address
-
11301 WILSHIRE BLVD # 117LOS ANGELES, CA, 900731003Browse CA providers · Browse ZIP 90073
- Phone
- 5622617638
- Primary Specialty
-
Primary Care Nurse Practitioner
363LP2300X
- Additional Specialty
- Primary Care Nurse Practitioner
Other Primary Care Nurse Practitioner Providers in LOS ANGELES, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. LISA LI HSIEH | APRN | 1255381901 |
| MS. CAROL M VAZIRZADEH KAMJOU | NP | 1427094333 |
| HAMIDEH POURZAND | RN, NP, MSN | 1700968955 |
| LORNA M JOHNSON | — | 1417005695 |
| SUSAN M. HUNT | N.P. | 1477692192 |
| MRS. CHRISTINA MARIE LEWIS | NP | 1699899641 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.