| Doctor Name: | NICHOLE A. TYSON |
| NPI Number: | 1285712976 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | A62283 |
| Business Practice Address: | 1600 Eureka Rd Mob 2, 3rd Floor Roseville, CA - 956613027 |
| Business Phone Number: | 9164742562 |
| Business Fax Number: | |
| Mailing Address: | 1800 Harrison St Fl 7, OAKLAND |
| State: | CA |
| Postal Code: | 946123429 |
| Phone Number: | 5106256262 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 05/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | A62283 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |