Provider Demographics
NPI:1386008779
Name:CATES, NICOLE KRISTEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:KRISTEN
Last Name:CATES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:KRISTEN
Other - Last Name:AVERSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2299 POST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3443
Mailing Address - Country:US
Mailing Address - Phone:415-923-0992
Mailing Address - Fax:415-923-1036
Practice Address - Street 1:2299 POST ST STE 103
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3443
Practice Address - Country:US
Practice Address - Phone:415-923-0992
Practice Address - Fax:415-923-1036
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAE5708213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program