Active NPI
Marguerite V McNickle
- Social Worker
- Pittsburg, CA
National Provider Identifier
1740534783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 34519
- Practice address
- 51 Marina Blvd
Pittsburg, CA 94565-2068 - Phone
- (925) 252-1111
- NPI assigned
- Oct 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 34519 | CA | Primary |
Addresses
Primary practice location
51 Marina Blvd
Pittsburg, CA 94565-2068
Mailing address
4368 Lincoln Ave
Oakland, CA 94602-2529
Phone (510) 531-3111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 20, 2024 through Oct 20, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34519 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 21566 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351468800000",
"number": "1740534783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4368 LINCOLN AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946022529",
"telephone_number": "510-531-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 MARINA BLVD",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945652068",
"telephone_number": "925-252-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNICKLE",
"first_name": "MARGUERITE",
"middle_name": "V",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-29",
"last_updated": "2012-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "34519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.