Healthcare Provider Details

I. General information

NPI: 1043930183
Provider Name (Legal Business Name): NICOLE BROWN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE LOEWER

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9830 PROSPECT AVE STE A
SANTEE CA
92071-4375
US

IV. Provider business mailing address

3070 MADISON ST
CARLSBAD CA
92008-2310
US

V. Phone/Fax

Practice location:
  • Phone: 619-448-4860
  • Fax: 619-448-1639
Mailing address:
  • Phone: 760-591-7750
  • Fax: 760-471-5139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: