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RAEVIN NICKERSON RAD-T
NPI 1487438594
Counselor - Addiction (Substance Use Disorder) in Fairfield, CA

Active since August 21, 2023
1225 TRAVIS BLVD, FAIRFIELD, CA 94533(707) 399-9105 Get Directions Write a Review

NPPES record last updated: August 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Raevin Nickerson Rad-t NPPES

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

RAEVIN NICKERSON RAD-T (NPI 1487438594) is an individual addiction (substance use disorder) provider in Fairfield, California, licensed in California (R1521270823) and active in the NPI registry since August 2023.

NPPES Registry Identity

NPI1487438594
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameRAEVIN NICKERSONCredential: RAD-T
Location Address1225 TRAVIS BLVDFairfield, CA 94533-4892
Mailing Address609 Jefferson StFairfield, CA 94533-6293 · (073) 999-1907
Phone(707) 399-9105
Sole ProprietorNo
Enumeration DateAugust 21, 2023
NPPES CertifiedAugust 21, 2023
✔ NPI 1487438594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1521270823
1225 TRAVIS BLVD, Fairfield, CA 94533
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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS MARIE VENTURA RAD-T
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (707) 399-9105
KIMBERLY JOHNSON RAD-T
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (707) 399-9105
THERESA PORTER RADT
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (707) 399-9105
CHRISTOPHER MICHAEL AUDETTE APCC
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (073) 999-1907
MARTA ENGLEMAN RADT-T
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (707) 399-9190
DR. ANTONIO BESERRA ZARATE DDS
Dentist (General Practice)
1225 TRAVIS BLVD, STE. B
FAIRFIELD, CA 94533
Solano County (707) 425-0225
JESSICA L BASSETT RAD-T1
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (707) 399-9190
DEMPSEY JORDAN CRISPIERI SUDRC
Counselor (Addiction (Substance Use Disorder))
1225 TRAVIS BLVD
FAIRFIELD, CA 94533
Solano County (073) 999-1907

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raevin Nickerson's NPI number?

The NPI number for Raevin Nickerson is 1487438594. It was assigned to this individual provider in the NPPES registry on August 21, 2023.

Where is Raevin Nickerson located?

Raevin Nickerson practices at 1225 Travis Blvd, Fairfield, CA 94533. The listed phone number is (707) 399-9105.

What is Raevin Nickerson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Raevin Nickerson was last updated on August 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.