Individual provider Active NPI

Nicole Marie Keaton, LCSW

  • Clinical Social Worker
  • Oceanside, CA
National Provider Identifier
1730929951
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121891 Issued in CA
Practice address
3609 Ocean Ranch Blvd Ste 208&209
Oceanside, CA 92056-2698
Phone
(858) 279-1223
NPI assigned
May 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 121891 CA Primary

Addresses

Primary practice location

3609 Ocean Ranch Blvd Ste 208&209
Oceanside, CA 92056-2698

Mailing address

3609 Ocean Ranch Blvd Ste 208&209
Oceanside, CA 92056-2698

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: No
  • 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
121891CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

3609 Ocean Ranch Blvd
Ste 209
Oceanside, CA 92056

3609 Ocean Ranch Blvd
Ste 208209
Oceanside, CA 92056
Phone (858) 898-0549

3609 Ocean Ranch Blvd
Ste 208
Oceanside, CA 92056
Phone (760) 450-7859

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1730929951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 OCEAN RANCH BLVD STE 208&209",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 OCEAN RANCH BLVD STE 208&209",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562698",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.