Active NPI
Nicole Medina
- Clinical Social Worker
- South Pasadena, CA
National Provider Identifier
1477466332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 140949
- Practice address
- 205 Pasadena Ave
South Pasadena, CA 91030-2919 - Phone
- (323) 344-5536
- NPI assigned
- Sep 23, 2026
- Last updated
- Sep 23, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 140949 | CA | Primary |
Addresses
Primary practice location
205 Pasadena Ave
South Pasadena, CA 91030-2919
Mailing address
205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone (323) 344-5536
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7368 | Other | CA | MEDICAL |
| 7708 | Other | CA | MEDICAL |
| 7667 | Other | CA | MEDICAL |
| 7184 | Other | CA | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1477466332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 PASADENA AVE",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302919",
"telephone_number": "323-344-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 PASADENA AVE",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302919",
"telephone_number": "323-344-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "140949",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7368",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7708",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7667",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7184",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.