Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Terese Suprovici, MD

Individual provider Psychiatry Physician · NPI 1689715120

Nicole Terese Suprovici, MD is a Psychiatry Physician in San Quentin, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1 Main St
San Quentin, CA 94964-1000
Phone: (415) 454-1460
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence NONE (CA)

Record details

NPI number1689715120
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 9, 2007
Last updated in NPPESFebruary 9, 2016

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