Provider Demographics
NPI:1184144487
Name:LOSENICKY, NICOLAS SEAN
Entity type:Individual
Prefix:MR
First Name:NICOLAS
Middle Name:SEAN
Last Name:LOSENICKY
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 1:818 EQUINOX LOOP
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-2984
Mailing Address - Country:US
Mailing Address - Phone:916-203-2383
Mailing Address - Fax:
Practice Address - Street 1:818 EQUINOX LOOP
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648
Practice Address - Country:US
Practice Address - Phone:916-203-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)