Healthcare Provider Details

I. General information

NPI: 1952258071
Provider Name (Legal Business Name): NYKA MARIE SAINT JEAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 S GRAND AVE STE 2450
LOS ANGELES CA
90071-9500
US

IV. Provider business mailing address

355 S GRAND AVE STE 2450
LOS ANGELES CA
90071-9500
US

V. Phone/Fax

Practice location:
  • Phone: 323-471-1024
  • Fax:
Mailing address:
  • Phone: 323-471-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: