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Jack Nicholson
NPI 1831748318 · on the registry since 2019 · sole proprietor
Practice
- Address
- 460 Aztec Ln
Lathrop, CA 95330 - Phone
- (209) 451-8732
Registry record
- Primary taxonomy
- Attendant Care Provider
3747A0650X
- Also registered as
- Attendant Care Provider
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-09-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California