Individual provider Active NPI

Nichole Christine Mouriz, LCSW 139605

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1629768627
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
139605 Issued in CA
Practice address
45111 Fern Ave
Lancaster, CA 93534-2301
Phone
(661) 949-1206
NPI assigned
May 11, 2023
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 139605 CA Primary

Addresses

Primary practice location

45111 Fern Ave
Lancaster, CA 93534-2301

Mailing address

2010 W Avenue K # 1111
Lancaster, CA 93536-5229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
139605CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1629768627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W AVENUE K # 1111",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45111 FERN AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342301",
            "telephone_number": "661-949-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURIZ",
        "first_name": "NICHOLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW 139605",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "139605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.