Active NPI
Melanie Nichols, LMFT
- Marriage & Family Therapist
- Gold Run, CA
National Provider Identifier
1780920264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 87226
- Practice address
- 29920 Magra Rd
Gold Run, CA 95717 - Phone
- (530) 613-0685
- Fax
- (530) 613-0685
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 87226 | CA | Primary |
Addresses
Primary practice location
29920 Magra Rd
Gold Run, CA 95717
Mailing address
PO Box 7
Gold Run, CA 95717-0007
Phone (530) 613-0685
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250801003671 | CA | Practitioner - Marriage and Family Therapist | 9032627963 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140
Phone (323) 968-6182
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sud Specialty Group - Ca | Marriage & Family Therapist | Current | Accepting new patients |
Locations
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295
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.
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Santa Clara, CA
- NPI 1972138238
CA, Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1780920264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7",
"city": "GOLD RUN",
"state": "CA",
"postal_code": "957170007",
"telephone_number": "530-613-0685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29920 MAGRA RD",
"city": "GOLD RUN",
"state": "CA",
"postal_code": "95717",
"telephone_number": "530-613-0685",
"fax_number": "530-613-0685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "MELANIE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-02",
"last_updated": "2023-12-20",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "87226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.