Nicole Monica Waters, PSY.D., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

91190 Issued in CA

Practice address

65 Main St
Quincy, CA 95971-9494

Phone

(530) 283-2465

NPI assigned

Jan 21, 2011

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

Other names 1

• Miss Nicole Monica Duggan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 18, 2024 through Oct 18, 2026

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.

• Kinne Marriage and Family Therapy, Inc.

  dba Rethink Industries

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, CA
  • NPI 1609337377

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1326343302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15392 MURIETA SOUTH PKWY",
            "city": "RANCHO MURIETA",
            "state": "CA",
            "postal_code": "956839180",
            "telephone_number": "530-591-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MAIN ST",
            "city": "QUINCY",
            "state": "CA",
            "postal_code": "959719494",
            "telephone_number": "530-283-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "NICOLE",
        "middle_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 72481",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DUGGAN",
            "middle_name": "MONICA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bruce John Walker, D.C.
• Sarah Wallace
• Steven Earl Wallace, RPA
• Matthew Ward
• Cynthia Warner
• Rhonda Lynne Wayson, MS
• Brittnee Wightman
• Kathryn D Williams, LCSW
• Toni Marie Williams
• Tammy Woden

• Marriage & Family Therapist in Quincy, CA
• Providers in Quincy, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.