Individual provider Active NPI

Nicole E Williams, M.A., LMFT

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1962687491
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
115146 Issued in CA
Practice address
784 High St
San Luis Obispo, CA 93401-5243
Phone
(805) 503-3502
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 115146 CA Primary

Addresses

Primary practice location

784 High St
San Luis Obispo, CA 93401-5243

Mailing address

PO Box 3420
Shell Beach, CA 93448-3420
Phone (805) 904-9762

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250916004713 CA Practitioner - Marriage and Family Therapist 7810491529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

234 W Branch St
Arroyo Grande, CA 93420-2614

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Aug 27, 2025 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1962687491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3420",
            "city": "SHELL BEACH",
            "state": "CA",
            "postal_code": "934483420",
            "telephone_number": "805-904-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 HIGH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015243",
            "telephone_number": "805-503-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLE",
        "middle_name": "E",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2021-05-21",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.