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Nicole Rose Detore
Student in an Organized Health Care Education/Training Program in Culver City, California
NPI 1184057036

Nicole Rose Detore is a Student in an Organized Health Care Education/Training Program based in Culver City, CA. Nicole Rose Detore practices in Culver City, CA. The NPI Number for Nicole Rose Detore is 1184057036 and holds a License No. (California).

The current practice location address for Nicole Rose Detore is 4760 Sepulveda Blvd, Culver City, CA and can be reached out via phone at 310-751-5344.

Location: 4760 Sepulveda Blvd, Culver City, CA, 90230-4820
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184057036
Provider Name
Nicole Rose Detore
Credential
Provider Entity Type
Individual
Gender
Female
Address
4760 Sepulveda Blvd, Culver City, CA, 90230-4820
Phone Number
310-751-5344
Fax Number
Provider Enumeration Date
08/14/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
310-751-5344
Fax Number
person
Provider Business Mailing Address Details
Address
4760 Sepulveda Blvd
City
Culver City
State
California
Zip
90230-4820
Phone Number
310-751-5344
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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