Myriame Mia Nicolas, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP95024480 Issued in CA

Practice address

158 C Ave
Coronado, CA 92118-1420

Phone

(619) 435-5400

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Crownview Medical Group IncGroup PAC ID 2668524323, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crownview Medical Group, Inc

  • Psychiatry Physician
  • Coronado, CA
  • NPI 1598928798
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1063106805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 C AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181420",
            "telephone_number": "619-435-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 C AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181420",
            "telephone_number": "619-435-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAS",
        "first_name": "MYRIAME",
        "middle_name": "MIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95024480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph L Nelson, RPH
• Neo-Balance Marriage Therapy and Recovery, PC
• Michelle Laura NG, PHARMD
• Hue Nguyen, PHARMD
• Lillian Tran Nguyen, PHARM.D.
• Lyssia O'Shaughnessy, MA
• Roger Oen, M.D.
• Lindsay Olson Mack, NP
• One Life Physical Therapy Inc
• P Paul Chillar MD PC

• Psychiatric/Mental Health Nurse Practitioner in Coronado, CA
• Providers in Coronado, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.