Provider Demographics
NPI:1316824089
Name:VASOYA, NIKITA KALU (PA)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:KALU
Last Name:VASOYA
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5620 PICASSO DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-5606
Mailing Address - Country:US
Mailing Address - Phone:714-600-9959
Mailing Address - Fax:
Practice Address - Street 1:2575 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-1699
Practice Address - Country:US
Practice Address - Phone:714-449-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical