Nicky Deastra
ActiveCalifornia license 559156
License
- Licensed by
- Medical Board of California
- License number
- 559156
- Status
- Active (Current)
- First issued
- April 4, 2025
- Expires
- April 30, 2027
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1801 Wilshire Blvd # 100
Santa Monica, CA 90403-5609
Santa Monica, CA 90403-5609
Los Angeles County