Individual provider Active NPI

Niki Nakamura, SUDRC I

  • Addiction (Substance Use Disorder) Counselor
  • San Mateo, CA
National Provider Identifier
1396684718
Registry record updated Mar 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
24352 Issued in CA
Practice address
2251 Palm Ave
San Mateo, CA 94403-1814
Phone
(650) 513-6500
NPI assigned
Mar 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 24352 CA Primary

Addresses

Primary practice location

2251 Palm Ave
San Mateo, CA 94403-1814

Mailing address

PO Box 620204
Woodside, CA 94062-0204
Phone (650) 640-6607

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

LicenseStateTypeSpecialty
24352CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Services, Incorporated Past Accepting new patients
Horizon Services Inc. PastSince Apr 14, 2024 Accepting new patients

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": "1774656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774656000000",
    "number": "1396684718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620204",
            "city": "WOODSIDE",
            "state": "CA",
            "postal_code": "940620204",
            "telephone_number": "650-640-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 PALM AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031814",
            "telephone_number": "650-513-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "NIKI",
        "credential": "SUDRC I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-28",
        "last_updated": "2026-03-28",
        "certification_date": "2026-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "24352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2026; 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.