Individual provider Active NPI

Elaine J Nicholas

  • Marriage & Family Therapist
  • Richmond, CA
National Provider Identifier
1366599524
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
99062 Issued in CA
Practice address
13585 San Pablo Ave FL 2
Richmond, CA 94806-3863
Phone
(510) 942-4700
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 124539350 CA
Marriage & Family Therapist 106H00000X 99062 CA Primary

Addresses

Primary practice location

13585 San Pablo Ave FL 2
Richmond, CA 94806-3863

Mailing address

PO Box 156573
San Francisco, CA 94115-6573
Phone (415) 517-6857

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611001759 CA Practitioner - Marriage and Family Therapist 3678083342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians

Practice addresses (Care Compare)

13585 San Pablo Ave
FL 2
San Pablo, CA 94806-3804
Phone (510) 942-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124539350CAMDMental Health Counselor
99062CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Apr 9, 2025 Accepting new patients
Contra Costa County CurrentSince Apr 9, 2025 Accepting new patients
Contra Costa County Current Accepting new patients

Locations

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

13585 San Pablo Ave
Fl 2
San Pablo, CA 94806
Phone (510) 942-4700

Organizations & group practices 3

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1366599524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156573",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941156573",
            "telephone_number": "415-517-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVE FL 2",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948063863",
            "telephone_number": "510-942-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "ELAINE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "124539350",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.