MR. MERVYN BERTRAND NICHOLAS PA
NPI 1104854728
Physician Assistant - Medical in Vallejo, CA

Q: What is Mervyn Nicholas's NPI number?

The NPI number for Mervyn Nicholas is 1104854728. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Q: What is Mervyn Nicholas's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Mervyn Nicholas was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 30, 2006

5505 BORDEAUX CT, VALLEJO, CA 94591(707) 980-0372(925) 372-2804 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Mervyn Bertrand Nicholas Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MERVYN BERTRAND NICHOLAS PA (NPI 1104854728) is an individual medical provider in Vallejo, California, licensed in California (PA15023) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1104854728

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. MERVYN BERTRAND NICHOLASCredential: PA

Location Address5505 BORDEAUX CTVallejo, CA 94591-6308

Mailing Address5505 Bordeaux CtVallejo, CA 94591-6308 · (707) 980-0372 · Fax (925) 372-2804

Phone(707) 980-0372

Fax(925) 372-2804

Sole ProprietorNo

Enumeration DateJune 30, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1104854728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA15023

5505 BORDEAUX CT, Vallejo, CA 94591

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mervyn Nicholas's NPI number?

The NPI number for Mervyn Nicholas is 1104854728. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Where is Mervyn Nicholas located?

Mervyn Nicholas practices at 5505 Bordeaux Ct, Vallejo, CA 94591. The listed phone number is (707) 980-0372.

What is Mervyn Nicholas's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Mervyn Nicholas was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.