Daisa, Nicole Marie

Daisa, Nicole Marie is an individual health care provider with primary practice located at 575 Lennon Ln , Walnut Creek CA 94598-2443. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Daisa, Nicole Marie can be contacted via phone (925) 433-8786.

Contact Information

Primary practice address
575 Lennon Ln Walnut Creek CA 94598-2443
Phone: (925) 433-8786
Fax: (925) 433-8788
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 95415429 California
Nursing Service Providers / Registered Nurse 163W00000X RN60666816 Washington
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP60782216 Washington
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95035040 California

Profile Details

NPI number 1861924516
LBN Legal business name Daisa, Nicole Marie
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2017
Last updated Jun 24th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861924516 NPPES
Washington MEDICAID 2106150

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