Basic Information
| Provider Information | |||||||||
| NPI: | 1376975623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMSTRONG | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | ANDREA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LEMBKE | ||||||||
| OtherFirstName: | NICOLE | ||||||||
| OtherMiddleName: | ANDREA | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 225 37TH AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944034324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505732541 | ||||||||
| FaxNumber: | 6505732841 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 37TH AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944034324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505732541 | ||||||||
| FaxNumber: | 6505732841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2013 | ||||||||
| LastUpdateDate: | 08/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.