Provider Demographics
NPI:1760751457
Name:NISHIIKE, YUI (NP)
Entity Type:Individual
Prefix:
First Name:YUI
Middle Name:
Last Name:NISHIIKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2412
Mailing Address - Country:US
Mailing Address - Phone:510-981-4200
Mailing Address - Fax:510-981-4243
Practice Address - Street 1:2031 6TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2006
Practice Address - Country:US
Practice Address - Phone:510-981-4200
Practice Address - Fax:510-981-4243
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-24
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA765804163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse