Lena Lisa Nicklas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW83411 Issued in CA

Practice address

1001 N Tustin Ave
Santa Ana, CA 92705-3502

Phone

(714) 953-3500

NPI assigned

Oct 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• New Foundation Medical Inc.

  • Multi-Specialty Clinic/Center
  • Santa Ana, CA
  • NPI 1689023582

  Clinical

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1942510011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053502",
            "telephone_number": "323-335-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053502",
            "telephone_number": "714-953-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3828 Delmas Ter",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902322713",
            "country_code": "US",
            "telephone_number": "310-836-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKLAS",
        "first_name": "LENA",
        "middle_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2021-11-22",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076370-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW83411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elsie Ngoc My Nguyensi, RN, PHN
• Nguyentran DDS Corp
• Maria A Nicholas
• Diana Robles Nichols
• Meagan Camille Nicholson
• Dylan Nicolette
• Duane Hugh Nielsen, ARRT, CRT
• Nancy Nieto, SLPA
• Stacey Max Nijst, CADCA, CCJP
• Nilar Thein DDS a Professional Corporation

• Clinical Social Worker in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.