Individual provider Active NPI

Nicole Leslie Piquant

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1174341002
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95030528 Issued in CA
Practice address
2531 W Woodland Dr
Anaheim, CA 92801-2637
Phone
(714) 226-9888
NPI assigned
Sep 30, 2024
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95030528 CA Primary

Addresses

Primary practice location

2531 W Woodland Dr
Anaheim, CA 92801-2637

Mailing address

1525 N Alvarado Street
#26214
Los Angeles, CA 90026
Phone (646) 407-8469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120003418 CA Practitioner - Nurse Practitioner 1557896057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aleksandra Wirga, M.D., Inc.Group PAC ID 3072649722, 12 clinicians

Practice addresses (Care Compare)

3703 Long Beach Blvd
Suite 400
Long Beach, CA 90807-3332
Phone (562) 427-3897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Nov 1, 2024 Accepting new patients
Telecare Corporation CurrentSince Nov 1, 2024 Accepting new patients
Aleksandra Wirga, M.D., Inc. CurrentSince Mar 20, 2025 Accepting new patients
Telecare Corporation Current Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

2531 W Woodland Dr
Anaheim, CA 92801
Phone (714) 338-1017

3703 Long Beach Blvd
Ste 400
Long Beach, CA 90807
Phone (562) 427-3897

2100 N Broadway
Ste 101
Santa Ana, CA 92706
Phone (714) 245-6881

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1174341002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 N ALVARADO STREET",
            "address_2": "#26214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90026",
            "telephone_number": "646-407-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 W WOODLAND DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012637",
            "telephone_number": "714-226-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIQUANT",
        "first_name": "NICOLE",
        "middle_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95030528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.