Nicki Kiyomi Bartholomy

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

ASW115681 Issued in CA

Practice address

16756 Chino Corona Rd
Corona, CA 92880-9508

Phone

(909) 597-1771

NPI assigned

Jun 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Corona, CA
  • NPI 1578199741
  NPD
• State of California

  • Psychiatric Hospital
  • Corona, CA
  • NPI 1366783169
  NPD (past)

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1235861972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16756 CHINO CORONA RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928809508",
            "telephone_number": "909-597-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16756 CHINO CORONA RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928809508",
            "telephone_number": "909-597-1771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9864 Baldwin Pl",
            "address_purpose": "LOCATION",
            "city": "El Monte",
            "state": "CA",
            "postal_code": "917312202",
            "country_code": "US",
            "telephone_number": "626-433-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTHOLOMY",
        "first_name": "NICKI",
        "middle_name": "KIYOMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2024-04-03",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW115681",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "ASW115681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Barrera
• Barrett Villa
• Jenifer Christine Barrett, MSW, LCSW
• Crystal Jazmin Barrientos
• Sylvia Barrow
• Larissa Mary Barton Anderson
• Taylor Barton
• Ahsan Baseer, PH.D., MT(ASCP), CLS
• Mudhar Basim
• Jesus Alberto Basurto

• Student in an Organized Health Care Education/Training Program in Corona, CA
• Providers in Corona, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.