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General NPI Number Information
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NPI Number | 1013446228
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Entity Type | Individual
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Provider Name | ANGELA NICOLINI D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 10200 TRINITY PARKWAY SUITE 102
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City | STOCKTON
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State | CA
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Zip | 95219
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Country | US
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Telephone | 209-948-0808
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Fax | 209-957-1807
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Provider Business Mailing Address
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Address Line | 10200 TRINITY PKWY STE 102
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City | STOCKTON
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State | CA
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Zip | 95219-7287
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Country | US
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Telephone | 209-948-0808
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Fax | 209-957-1807
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A17995
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License Number State | CA
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