MEDICARE: NICOLE ELIZABETH HATCHARD DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	25027	CA

General Provider Information

NPI Number	:	1164001830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ELIZABETH HATCHARD DO

Provider Business Mailing Address
First Line	:	4860 Y ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4860 Y ST # 3020
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-734-6688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	05/29/2026

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