Active NPI
Melisa Nicholson, LCSW
- Clinical Social Worker
- Mission Viejo, CA
National Provider Identifier
1407206261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 107541
- Practice address
- 27800 Medical Center Rd
Mission Viejo, CA 92691-6410 - Phone
- (949) 866-3600
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 107541 | CA | Primary |
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X |
Addresses
Primary practice location
27800 Medical Center Rd
Mission Viejo, CA 92691-6410
Mailing address
11481 American River Rd
Corona, CA 92878-9416
Phone (714) 398-2938
Other practice location 1
801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846
Phone (714) 680-9000 ext. 9034
Other names 1
- Melisa Villanueva
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
| License | State | Type | Specialty |
|---|---|---|---|
| 107541 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1407206261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11481 AMERICAN RIVER RD",
"city": "CORONA",
"state": "CA",
"postal_code": "928789416",
"telephone_number": "714-398-2938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27800 MEDICAL CENTER RD",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916410",
"telephone_number": "949-866-3600"
}
],
"practiceLocations": [
{
"address_1": "801 E Chapman Ave Ste 203",
"address_purpose": "LOCATION",
"city": "Fullerton",
"state": "CA",
"postal_code": "928313846",
"country_code": "US",
"telephone_number": "714-680-9000 x9034",
"fax_number": "714-680-8239",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLSON",
"first_name": "MELISA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "107541",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISA",
"last_name": "VILLANUEVA",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.