Active NPI
Nikole L. Heredia, L.C.S.W.
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1992052187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 24022
- Practice address
- 2500 Wilshire Blvd
7TH FL
Los Angeles, CA 90057-4303 - Phone
- (213) 639-2674
- NPI assigned
- Aug 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 24022 | CA | Primary |
Addresses
Primary practice location
2500 Wilshire Blvd
7TH FL
Los Angeles, CA 90057-4303
Mailing address
2500 Wilshire Blvd
7TH FL
Los Angeles, CA 90057-4303
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24022 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Past | Accepting new patients | |
| Pacific Clinics | 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
- Irwindale, CA
- NPI 1821495003
-
- Community/Behavioral Health Agency
- Ontario, CA
- NPI 1902273923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344297600000",
"number": "1992052187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 WILSHIRE BLVD",
"address_2": "7TH FL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900574303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 WILSHIRE BLVD",
"address_2": "7TH FL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900574303",
"telephone_number": "213-639-2674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREDIA",
"first_name": "NIKOLE",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-07",
"last_updated": "2012-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "24022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.