Mrs Kimberly Ruth Nicolson, DSW, LCSW is a medicare enrolled "Social Worker" provider in Redondo Beach, California. Her current practice location is
1840 S Elena Ave Ste 106, Redondo Beach, California. You can reach out to her office (for appointments etc.) via phone at
(310) 737-2210.
Mrs Kimberly Ruth Nicolson is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164617015.
Healthcare Provider's Profile
Full Name | Mrs Kimberly Ruth Nicolson |
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Gender | Female |
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Speciality | Social Worker |
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Location | 1840 S Elena Ave Ste 106, Redondo Beach, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164617015
- Provider Enumeration Date: 09/12/2007
- Last Update Date: 12/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860867629
- Enrollment ID: I20230407001779
Medical Identifiers
Medical identifiers for Mrs Kimberly Ruth Nicolson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164617015 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 62673 (California) | Secondary |
104100000X | Social Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kimberly Ruth Nicolson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Kimberly Ruth Nicolson, DSW, LCSW 1840 S Elena Ave Ste 106, Redondo Beach, CA 90277-5716 Ph: (310) 737-2210 | Mrs Kimberly Ruth Nicolson, DSW, LCSW 1840 S Elena Ave Ste 106, Redondo Beach, CA 90277-5716 Ph: (310) 737-2210 |
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