Healthcare Provider Details

I. General information

NPI: 1609317882
Provider Name (Legal Business Name): NIKA ALEXA VIZCARRA MD, MS, FACOG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91605-5162
US

IV. Provider business mailing address

3135 YORKSHIRE WAY
ROWLAND HEIGHTS CA
91748-5119
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-8836
  • Fax:
Mailing address:
  • Phone: 626-944-2289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number21385
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA191817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: