Nicolas Der, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

784306 Issued in CA

Practice address

855 Veterans Blvd
Redwood City, CA 94063-1712

Phone

(650) 817-9070

Fax

(650) 246-3838

NPI assigned

Oct 2, 2012

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1609128552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 30TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161149",
            "telephone_number": "650-817-9070",
            "fax_number": "650-246-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 VETERANS BLVD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631712",
            "telephone_number": "650-817-9070",
            "fax_number": "650-246-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DER",
        "first_name": "NICOLAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "784306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Denenberg, RPT
• Steve Deng, DDS
• Denise Kan MD
• Aundrea Laureen Dennis, CMT
• Susan Lee Dennis, MFT
• Yesica Deras
• Jessica Lee Derise, LCSW-C
• Anup Mahesh Desai, M.D.
• Mayuri Desai, MD
• Josephine Destin

• Medical-Surgical Registered Nurse in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.