Mariane Margurette Nicholson, SUDRC 17478

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17478 Issued in CA

Practice address

710 N Anaheim Blvd
Anaheim, CA 92805-2651

Phone

(714) 776-7490

NPI assigned

Feb 23, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Hope House Corporation

  • Substance Abuse Rehabilitation Facility
  • Anaheim, CA
  • NPI 1578646469
  NPD

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1548026933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052651",
            "telephone_number": "714-776-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052651",
            "telephone_number": "714-776-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MARIANE",
        "middle_name": "MARGURETTE",
        "credential": "SUDRC 17478",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "17478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Nguyen
• Nguyet Le MD Inc
• Anong Nhim, M.A.
• Nicholas L. Brown Chiropractic, a Professional Corporation
• Crystal Nicholson-Brain, MA, BCBA
• Ashley Elizabeth Nickell, OD
• Adrian Christopher Nickolescu, MD
• Epifania Viola Nicolas, DDS
• Nicole Ann Garcia
• Nicole Sharkey, MD, Inc

• Addiction (Substance Use Disorder) Counselor in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.