Nicole Terese Suprovici, MD
NPI #1689715120 in San Quentin, California
Provider Information
- NPI Number
- 1689715120
- Entity Type
- Individual
- Name
- Nicole Terese Suprovici, MD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Credential
- MD
- Enumeration Date
- Feb 9, 2007
- Last Updated
- Feb 9, 2016
Practice Location
- Address
- 1 MAIN ST
- City
- San Quentin
- State
- California
- ZIP Code
- 94964-1000
- Phone
- (415) 454-1460
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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