Lamar Ray Nicholson
Individual provider Active NPI Attendant Care Provider · Adelanto, CA
NPI 1891380705 · NPPES record last updated Mar 2, 2021
Key facts
- NPI
- 1891380705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 10478 Thorndale St
Adelanto, CA 92301-4887 - Phone
- (909) 730-5136
- NPI assigned
- Mar 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
10478 Thorndale St
Adelanto, CA 92301-4887
Mailing address
10478 Thorndale St
Adelanto, CA 92301-4887
Phone (909) 730-5136
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All providers in Adelanto, CA · Attendant Care Provider in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.