Nicolette Gubicza, LMFT 121814

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

121814 Issued in CA

Practice address

60 Via Cartama
San Clemente, CA 92673-6998

Phone

(818) 800-5627

NPI assigned

Oct 30, 2020

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

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1609476332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 VIA CARTAMA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736998",
            "telephone_number": "818-800-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 VIA CARTAMA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736998",
            "telephone_number": "818-800-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBICZA",
        "first_name": "NICOLETTE",
        "credential": "LMFT 121814",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.