Active NPI
Michelle Nedwek
- Marriage & Family Therapist
- Riverside, CA
National Provider Identifier
1821520552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 9890 County Farm Rd
Ste 2
Riverside, CA 92503 - Phone
- (909) 509-2499
- NPI assigned
- Mar 31, 2017
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
9890 County Farm Rd
Ste 2
Riverside, CA 92503
Mailing address
24885 Whitewood Rd Ste 105
Murrieta, CA 92563-2004
Phone (951) 683-6596
Other practice location 1
600 Central Ave Ste E1
Lake Elsinore, CA 92530-2740
Phone (951) 471-1426
Other practice location 2
24885 Whitewood Rd Ste 105
Murrieta, CA 92563
Phone (951) 683-6596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821520552 | Medicaid | CA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mfi Recovery Center | Past | Accepting new patients | |
| Community Access Network Non Profit Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Lake Elsinore, CA
- NPI 1518298702
-
- Substance Abuse Rehabilitation Facility
- Murrieta, CA
- NPI 1689851917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1821520552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24885 WHITEWOOD RD STE 105",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925632004",
"telephone_number": "951-683-6596",
"fax_number": "951-471-1453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9890 COUNTY FARM RD",
"address_2": "STE 2",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92503",
"telephone_number": "909-509-2499"
}
],
"practiceLocations": [
{
"address_1": "600 Central Ave Ste E1",
"address_purpose": "LOCATION",
"city": "Lake Elsinore",
"state": "CA",
"postal_code": "925302740",
"country_code": "US",
"telephone_number": "951-471-1426",
"fax_number": "951-471-1453",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "24885 Whitewood Rd Ste 105",
"address_purpose": "LOCATION",
"city": "Murrieta",
"state": "CA",
"postal_code": "92563",
"country_code": "US",
"telephone_number": "951-683-6596",
"fax_number": "951-471-1453",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEDWEK",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-31",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821520552",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.