Provider Demographics
NPI:1316779812
Name:CALKINS, NICHOLAS S
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:S
Last Name:CALKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 MARKET ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4919
Mailing Address - Country:US
Mailing Address - Phone:415-608-3547
Mailing Address - Fax:415-915-0909
Practice Address - Street 1:1182 MARKET ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4919
Practice Address - Country:US
Practice Address - Phone:415-608-3547
Practice Address - Fax:415-915-0909
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker