MEDICARE: MS. NICOLE AGOSTINO EWENS M.S. PA-C

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	363A00000X	Physician Assistant	23300	CA

General Provider Information

NPI Number	:	1285061705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE AGOSTINO EWENS M.S. PA-C

Provider Business Mailing Address
First Line	:	8239 ROCHESTER AVE STE 120
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-0715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1873 COMMERCENTER W
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-3303
Country	:	US
Telephone Number	:	719-633-6373
Fax Number	:

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

Provider Enumeration Date	:	09/29/2013
Last Update Date	:	09/28/2022

Similar Medicare Providers

1003885518 — PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES INC.
Practice Location Address:

1873 COMMERCE CENTER WEST
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-890-5511
Practice Fax: 909-890-4599

1154433076 — DESAI DRUGS INC
Practice Location Address:

1823 COMMERCENTER W
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-570-2339
Practice Fax: 877-220-0199

1851516538 — SANDRA PEEKE FNP
Practice Location Address:

1873 COMMERCENTER W
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-890-5511
Practice Fax:

1760602692 — DR. SUMIT DESAI PHARM.D.
Practice Location Address:

1823 COMMERCENTER W , SUITE A
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-570-2339
Practice Fax:

1225237027 — MS. MELODY A LEHMAN RN
Practice Location Address:

1873 COMMERCENTER W
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-890-5511
Practice Fax:

1245408558 — MS. MITSU MARIE KILLION P.A.-C
Practice Location Address:

1873 COMMERCENTER W
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-890-5511
Practice Fax:

1083863492 — ELIZABETH ASHLEY MEADE N.P.
Practice Location Address:

1873 COMMERCENTER W
SAN BERNARDINO, CA
92408-3303

Practice Phone: 909-890-5511
Practice Fax: 909-890-4599

Directions to “ MS. NICOLE AGOSTINO EWENS M.S. PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.