Healthcare Provider Details

I. General information

NPI: 1578328704
Provider Name (Legal Business Name): NIKKA PEARL PILPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W TURNER RD STE 250
LODI CA
95242-2192
US

IV. Provider business mailing address

408 HIGUERA ST STE 200
SAN LUIS OBISPO CA
93401-6135
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-2224
  • Fax: 209-334-2225
Mailing address:
  • Phone: 805-788-0805
  • Fax: 805-788-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303865
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: