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NPI Code Detail

MEDICARE: NICOLE KIM ALVARADO

MEDICARE: NICOLE KIM ALVARADO
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1972472660
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE KIM ALVARADO
Provider Business Mailing Address
First Line : 601 HERRICK AVE
Second Line :
City : EUREKA
State : CA
Zip : 95503-6316
Country : US
Telephone Number : 909-450-9697
Fax Number :
Provider Business Practice Location Address
First Line : 2505 LUCAS ST STE A
Second Line :
City : EUREKA
State : CA
Zip : 95501-3340
Country : US
Telephone Number : 707-442-0380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2025
Last Update Date : 02/13/2026

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Directions to “ NICOLE KIM ALVARADO ” Practice Location

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