Nikki Lynn Pedersen, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

108387 Issued in CA

Practice address

6635 Florence Ave Ste 101
Bell Gardens, CA 90201-4968

Phone

(323) 647-6740

NPI assigned

Nov 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nikki Lynn Vandergrift Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Enki Health Services, Inc

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1427500263
  NPD (past)

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1851860613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 FLORENCE AVE STE 101",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902014968",
            "telephone_number": "323-647-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6635 FLORENCE AVE STE 101",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902014968",
            "telephone_number": "323-647-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "NIKKI",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "VANDERGRIFT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Ortiz, MPH, RD
• Sarah Ortiz
• Jessica Lissette Palma
• Susan Jean Palmquist, P.T.
• Yogendra Patel, PHARMACIST
• Monica Martinez Peralta
• Socorro Perez Garcia
• Judith Perez Sanchez
• Madhuri Petkar, M. D.
• Derick Pham

• Marriage & Family Therapist in Bell Gardens, CA
• Providers in Bell Gardens, 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 May 4, 2022; 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.