Nicole Mitsuuchi, is a medicare enrolled "Social Worker - Clinical" provider in Torrance, California. Her current practice location is
19401 S Vermont Ave Ste A200, Torrance, California. You can reach out to her office (for appointments etc.) via phone at
(310) 323-6887.
Nicole Mitsuuchi is licensed to practice in California (license number 87218) 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 1740657733.
Healthcare Provider's Profile
| Full Name | Nicole Mitsuuchi |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 19401 S Vermont Ave Ste A200, Torrance, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1740657733
- Provider Enumeration Date: 08/26/2015
- Last Update Date: 12/21/2018
Medicare PECOS Information:
- PECOS PAC ID: 9032459102
- Enrollment ID: I20190327002804
Medical Identifiers
Medical identifiers for Nicole Mitsuuchi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1740657733 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 87218 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Mitsuuchi allows following entities to bill medicare on her behalf.
| Entity Name | Koba Psychological Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992329627
PECOS PAC ID: 4385064633
Enrollment ID: O20201026002575 |
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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. Nicole Mitsuuchi 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 |
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Nicole Mitsuuchi,
19401 S Vermont Ave Ste A200,
Torrance, CA 90502-4418
Ph: (310) 323-6887 | Nicole Mitsuuchi,
19401 S Vermont Ave Ste A200,
Torrance, CA 90502-4418
Ph: (310) 323-6887 |
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