Active NPI
Nesreen Khalil
- Professional Counselor
- Elk Grove, CA
National Provider Identifier
1750168464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17910
- Practice address
- 9340 E Stockton Blvd
Elk Grove, CA 95624-1563 - Phone
- (708) 539-0811
- NPI assigned
- Sep 14, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Community Health Worker | 172V00000X | |||
| Professional Counselor | 101YP2500X | 17910 | CA | Primary |
Addresses
Primary practice location
9340 E Stockton Blvd
Elk Grove, CA 95624-1563
Mailing address
9340 E Stockton Blvd
Elk Grove, CA 95624-1563
Phone (708) 539-0811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17910 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1750168464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9340 E STOCKTON BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956241563",
"telephone_number": "708-539-0811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9340 E STOCKTON BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956241563",
"telephone_number": "708-539-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIL",
"first_name": "NESREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-14",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "17910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.