Healthcare Provider Details

I. General information

NPI: 1659986339
Provider Name (Legal Business Name): NICKISHA KRISTINA JOYCE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOYCE BROWN PA

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PARNASSUS AVE # 700B
SAN FRANCISCO CA
94117-3608
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 415-651-3342
  • Fax: 424-526-3323
Mailing address:
  • Phone: 833-702-8383
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number68322
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9113544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: