NICOLE WILSON
NPI 1033576400
Social Worker - Clinical in Los Angeles, CA

Q: What is Nicole Wilson's NPI number?

The NPI number for Nicole Wilson is 1033576400. It was assigned to this individual provider in the NPPES registry on January 15, 2016.

Q: What is Nicole Wilson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Wilson was last updated on June 2, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 15, 2016PECOS Enrolled

4325 W SUNSET BLVD STE 206, LOS ANGELES, CA 90029(619) 722-0550 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 2, 2021, Jan 15, 2016 (2 updates tracked since 2016).

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About Nicole Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE WILSON (NPI 1033576400) is an individual clinical provider in Los Angeles, California, licensed in California (94855) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033576400

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameNICOLE WILSON

Location Address4325 W SUNSET BLVD STE 206Los Angeles, CA 90029-2180

Mailing AddressPo Box 16252San Diego, CA 92176-6252 · (619) 722-0550

Phone(619) 722-0550

Sole ProprietorNo

Enumeration DateJanuary 15, 2016

Last NPPES UpdateJune 2, 20212 updates tracked since enumeration

NPPES CertifiedJune 2, 2021

✔ NPI 1033576400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 94855

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

4325 W SUNSET BLVD STE 206, Los Angeles, CA 90029

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Wilson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90029 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $62.96 – $187.60

Typical copayment $0.00 (range $15.74 – $46.90)

Most-billed visit code NA

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.