Nicholette Issaevitch

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

1180 Currier Ave
Simi Valley, CA 93065-5104

Phone

(818) 681-4012

NPI assigned

Aug 12, 2019

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1801442314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 CURRIER AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655104",
            "telephone_number": "818-681-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 CURRIER AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655104",
            "telephone_number": "818-681-4012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15305 Rayen St",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913435117",
            "country_code": "US",
            "telephone_number": "818-892-3423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSAEVITCH",
        "first_name": "NICHOLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "95-2633765",
            "identifier": "106H00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.