Provider Demographics
NPI:1699950071
Name:KASHEFI, NIKOO D (FNP-BC)
Entity type:Individual
Prefix:
First Name:NIKOO
Middle Name:D
Last Name:KASHEFI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 GENESEE AVE
Mailing Address - Street 2:CARDIOLOGY
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1205
Mailing Address - Country:US
Mailing Address - Phone:858-752-8598
Mailing Address - Fax:858-626-6677
Practice Address - Street 1:9888 GENESEE AVE
Practice Address - Street 2:CARDIOLOGY
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1205
Practice Address - Country:US
Practice Address - Phone:858-752-8598
Practice Address - Fax:858-626-6677
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily