Active NPI
Nicol Alejandra Stolar-Peterson, LCSW
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1174957740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS26051
- Practice address
- 3564 Central Ave Ste 2D
Riverside, CA 92506-2705 - Phone
- (310) 422-4575
- NPI assigned
- Aug 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS26051 | CA | Primary |
Addresses
Primary practice location
3564 Central Ave Ste 2D
Riverside, CA 92506-2705
Mailing address
27890 Clinton Keith Road, #D-303
Murrieta, CA 92562
Phone (310) 422-4575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS26051 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377820800000",
"number": "1174957740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27890 CLINTON KEITH ROAD, #D-303",
"city": "MURRIETA",
"state": "CA",
"postal_code": "92562",
"telephone_number": "310-422-4575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3564 CENTRAL AVE STE 2D",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062705",
"telephone_number": "310-422-4575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLAR-PETERSON",
"first_name": "NICOL",
"middle_name": "ALEJANDRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-30",
"last_updated": "2013-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS26051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.