JACK LEE NICHOLSON I
NPI 1831748318
Technician - Attendant Care Provider in Lathrop, CA

Q: What is Jack Nicholson's NPI number?

The NPI number for Jack Nicholson is 1831748318. It was assigned to this individual provider in the NPPES registry on September 8, 2019.

Q: What is Jack Nicholson's specialty?

The primary specialty registered for this NPI is Technician, specializing in Attendant Care Provider, with taxonomy code 3747A0650X.

Q: When was this NPI record last updated?

The NPPES record for Jack Nicholson was last updated on September 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 September 08, 2019

460 AZTEC LN, LATHROP, CA 95330(209) 451-8732 Get Directions Write a Review

NPPES record last updated: September 8, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jack Lee Nicholson I NPPES

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

JACK LEE NICHOLSON I (NPI 1831748318) is an individual attendant care provider provider in Lathrop, California and active in the NPI registry since September 2019.

NPPES Registry Identity

NPI1831748318

Entity TypeIndividualMale

Primary Taxonomy3747A0650X

Provider Legal NameJACK LEE NICHOLSON I

Location Address460 AZTEC LNLathrop, CA 95330-9142

Mailing Address460 Aztec LnLathrop, CA 95330-9142

Phone(209) 451-8732

Sole ProprietorYes

Enumeration DateSeptember 8, 2019

✔ NPI 1831748318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Attendant Care ProviderNursing Service Related Providers

Taxonomy Code3747A0650X

Definition

An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.

460 AZTEC LN, Lathrop, CA 95330

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Other Identifiers 3

Medicaid3747A0650XCA

Medicaid193200000XCA

Medicaid1933200000XCA

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 Jack Nicholson's NPI number?

The NPI number for Jack Nicholson is 1831748318. It was assigned to this individual provider in the NPPES registry on September 8, 2019.

Where is Jack Nicholson located?

Jack Nicholson practices at 460 Aztec Ln, Lathrop, CA 95330. The listed phone number is (209) 451-8732.

What is Jack Nicholson's specialty?

The primary specialty registered for this NPI is Technician, specializing in Attendant Care Provider, with taxonomy code 3747A0650X.

When was this NPI record last updated?

The NPPES record for Jack Nicholson was last updated on September 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.