MEDICARE: NICOLE MICHIYO KIYOHARA MD

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	2084P0800X	Psychiatry Physician	168764	CA

General Provider Information

NPI Number	:	1972959013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MICHIYO KIYOHARA MD

Provider Business Mailing Address
First Line	:	2444 WILSHIRE BLVD STE 507
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5826
Country	:	US
Telephone Number	:	424-307-8283
Fax Number	:

Provider Business Practice Location Address
First Line	:	2444 WILSHIRE BLVD STE 507
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5826
Country	:	US
Telephone Number	:	424-307-8283
Fax Number	:

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

Provider Enumeration Date	:	05/08/2016
Last Update Date	:	12/02/2021

Similar Medicare Providers

1730030628 — BRYSON LOCHTE MD PC
Practice Location Address:

2444 WILSHIRE BLVD STE 507
SANTA MONICA, CA
90403-5826

Practice Phone: 310-256-1122
Practice Fax:

1487065678 — JANICE JONES, PH.D.
Practice Location Address:

2444 WILSHIRE BLVD STE 508
SANTA MONICA, CA
90403-5826

Practice Phone: 310-229-5249
Practice Fax:

1164817789 — KATHERINE UNVERFERTH M.D.
Practice Location Address:

2444 WILSHIRE BLVD STE 507
SANTA MONICA, CA
90403-5826

Practice Phone: 424-259-2766
Practice Fax: 888-850-1258

1457726242 — SOPHIE ROSSEEL
Practice Location Address:

2444 WILSHIRE BLVD STE 507
SANTA MONICA, CA
90403-5826

Practice Phone: 424-391-3307
Practice Fax:

1558148437 — MEGAN SHAINA BAKVA
Practice Location Address:

2444 WILSHIRE BLVD STE 508
SANTA MONICA, CA
90403-5826

Practice Phone: 415-532-3487
Practice Fax:

1336033307 — SIDNEY YADIDI CHIROPRACTIC
Practice Location Address:

2444 WILSHIRE BLVD STE 511
SANTA MONICA, CA
90403-5826

Practice Phone: 310-972-9456
Practice Fax: 424-407-0526

Directions to “ NICOLE MICHIYO KIYOHARA MD” 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.