Nicole Leslie Nilsen

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

54231 Issued in CA

Practice address

210 S de Lacey Ave
Pasadena, CA 91105-2048

Phone

(714) 680-9000

NPI assigned

Jul 28, 2009

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

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1942431721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 N VERDUGO RD UNIT 407",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082129",
            "telephone_number": "949-235-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S DE LACEY AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052048",
            "telephone_number": "714-680-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSEN",
        "first_name": "NICOLE",
        "middle_name": "LESLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Pasadena, CA
• Providers in Pasadena, 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 Jun 19, 2013; 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.