Jaquan Taylor Nicholson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1318 Gateview Ave
San Francisco, CA 94130

Phone

(415) 967-5334

NPI assigned

Jan 13, 2025

Last updated

Jan 21, 2025By the provider in NPPES

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

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1841000619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 CHINA BASIN ST APT 347",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582571",
            "telephone_number": "415-808-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 GATEVIEW AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94130",
            "telephone_number": "415-967-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JAQUAN",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ron Reed Nichols
• Shawn Michael Nichols
• William Silas Nichols, NP
• Devon Nicholson
• Erin Nicholson
• Lauren Yvonne Nicholson, RN
• Linda Jean Nicholson
• Lowell T. Nicholson, MD
• Megan Nicholson
• Stuart Alistair Nicholson, MBBS

• Community Health Worker in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.