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Alexandra Joan Nicklas
Student in an Organized Health Care Education/Training Program in Santa Cruz, California
NPI 1679886832

Alexandra Joan Nicklas is a Student in an Organized Health Care Education/Training Program based in Santa Cruz, CA. Alexandra Joan Nicklas practices in Santa Cruz, CA. The NPI Number for Alexandra Joan Nicklas is 1679886832 and holds a License No. (California).

The current practice location address for Alexandra Joan Nicklas is 126A Front Street, Santa Cruz, CA and can be reached out via phone at 831-427-9343.

Location: 126A Front Street, Santa Cruz, CA, 95062-1663
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679886832
Provider Name
Alexandra Joan Nicklas
Credential
Provider Entity Type
Individual
Gender
Female
Address
126A Front Street, Santa Cruz, CA, 95062-1663
Phone Number
831-427-9343
Fax Number
Provider Enumeration Date
07/16/2010
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
44AV 01 CA FS RES MHSS
MEDI-CAL PRV NBR 05 CA
institution
Provider Business Practice Location Address Details
Address
126A Front Street
City
Santa Cruz
State
California
Zip
95060
Phone Number
831-427-9343
Fax Number
person
Provider Business Mailing Address Details
Address
126A Front Street
City
Santa Cruz
State
California
Zip
95060
Phone Number
831-427-9343
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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