Individual provider Active NPI

Nicole Marie Glick, MSN, FNP-BC

  • Family Nurse Practitioner
  • Mission Viejo, CA
National Provider Identifier
1700323227
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005896 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 540
Mission Viejo, CA 92691-8029
Phone
(949) 364-6000
NPI assigned
Jan 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95005896 CA
Family Nurse Practitioner 363LF0000X 95005896 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 540
Mission Viejo, CA 92691-8029

Mailing address

26800 Crown Valley Pkwy Ste 540
Mission Viejo, CA 92691-8029
Phone (949) 364-6000

Other names 1

  • Nicole M Sallee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171219003431 CA Practitioner - Nurse Practitioner 1355609488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

831 Via Suerte
Suite 102
San Clemente, CA 92673-6531
Phone (949) 364-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005896CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 28, 2025 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Sterling Hospitalist Medical Group Inc CurrentSince Sep 29, 2020 Accepting new patients
Providence Medical Foundation CurrentSince Apr 28, 2025 Accepting new patients
Sterling Hospitalist Medical Group Inc CurrentSince Sep 29, 2020 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

11741 Valley View St
Ste A
Cypress, CA 90630
Phone (714) 897-1071

10800 Paramount Blvd
Ste 405
Downey, CA 90241
Phone (562) 382-6733

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

12566 Valley View St
Garden Grove, CA 92845
Phone (702) 329-0671

1414 S Grand Ave
Ste 475
Los Angeles, CA 90015
Phone (213) 742-0254

26800 Crown Valley Pkwy
Ste 540
Mission Viejo, CA 92691
Phone (949) 242-6915

Dept LA 25152
Pasadena, CA 91185

831 Via Suerte
Ste 102
San Clemente, CA 92673
Phone (949) 364-5600

Interoperability endpoints

  • Direct secure messaging: nglick3824956@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1700323227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 540",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 540",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-22",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95005896",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SALLEE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.