Haruyo Nishimura

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW98265 Issued in CA

Practice address

3725 Westwind Blvd Ste 100
Santa Rosa, CA 95403-9082

Phone

(707) 565-5978

NPI assigned

Dec 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1487029567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "GRATON",
            "state": "CA",
            "postal_code": "954440542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 WESTWIND BLVD STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954039082",
            "telephone_number": "707-565-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMURA",
        "first_name": "HARUYO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW98265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harit K. Nijjar, DDS
• Diane Trimingham Niles, D.D.S.
• John Walter Nimtz, MD
• Natalie Joy Nishikawa, PHARMD
• Kathleen Anne Nishimoto
• Marlin Nissen, RN
• Jonathon Michael Nixon, LMFT
• Rebecca Nixon
• Tom Nixon
• Anne Njenga

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.