Individual provider Active NPI

Karen Elizabeth Nickerson, LCSW

  • Clinical Social Worker
  • Murrieta, CA
National Provider Identifier
1376140020
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
129105 Issued in CA
Practice address
41760 Ivy St Ste 204
Murrieta, CA 92562-9416
Phone
(951) 698-3500
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 129105 CA Primary

Addresses

Primary practice location

41760 Ivy St Ste 204
Murrieta, CA 92562-9416

Mailing address

41760 Ivy St Ste 204
Murrieta, CA 92562-9416

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
I20250512002441 CA Practitioner - Clinical Social Worker 4880111921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129105CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Clinical CurrentSince May 2, 2025 Accepting new patients
Collaborative Psychology Group, a Professional Corporation CurrentSince Aug 18, 2024 Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

41760 Ivy St
Ste 204
Murrieta, CA 92562
Phone (951) 682-1488

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Interoperability endpoints

  • Direct secure messaging: karen.nickerson.p1@direct.sokya.nextgenshare.com

Organizations & group practices 2

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1376140020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41760 IVY ST STE 204",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41760 IVY ST STE 204",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629416",
            "telephone_number": "951-698-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.