Healthcare Provider Details

I. General information

NPI: 1912428574
Provider Name (Legal Business Name): NICOLE NAZ MEHR DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 08/07/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W ARRELLAGA ST STE E
SANTA BARBARA CA
93101-5948
US

IV. Provider business mailing address

101 W ARRELLAGA ST STE E
SANTA BARBARA CA
93101-5948
US

V. Phone/Fax

Practice location:
  • Phone: 805-699-5881
  • Fax: 805-244-0429
Mailing address:
  • Phone: 805-699-5881
  • Fax: 805-244-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5766
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: