Provider Demographics
NPI:1275007403
Name:NINCHAK, VIOLA (FNP)
Entity Type:Individual
Prefix:
First Name:VIOLA
Middle Name:
Last Name:NINCHAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 HIDDEN VALLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4219
Mailing Address - Country:US
Mailing Address - Phone:760-631-3000
Mailing Address - Fax:760-631-3016
Practice Address - Street 1:9850 GENESEE AVE STE 530
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1213
Practice Address - Country:US
Practice Address - Phone:760-631-3000
Practice Address - Fax:858-412-5028
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95062783163WP0809X
CA95010549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult