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RAZALYN DYAN NICKOLA MFT ASSOCIATE
NPI 1780233650
Counselor in Dublin, CA

Active since September 04, 2019PECOS Enrolled
5325 BRODER BLVD, DUBLIN, CA 94568(925) 803-7221 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2022, Sep 4, 2019 (2 updates tracked since 2019).

About Razalyn Dyan Nickola Mft Associate NPPES

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

RAZALYN DYAN NICKOLA MFT ASSOCIATE (NPI 1780233650) is an individual counselor in Dublin, California and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780233650
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameRAZALYN DYAN NICKOLACredential: MFT ASSOCIATE
Location Address5325 BRODER BLVDDublin, CA 94568-3309
Mailing Address2441 Doidge AvePinole, CA 94564-1008 · (510) 708-9886
Phone(925) 803-7221
Sole ProprietorYes
Enumeration DateSeptember 4, 2019
Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration
✔ NPI 1780233650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
5325 BRODER BLVD, Dublin, CA 94568
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Razalyn Dyan Nickola Mft Associate 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.

Medicare Billing Reassignment

Medicare enrollment records show Razalyn Nickola reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
24 mi
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

ANTOINETTE TAYLOR
Social Worker (Clinical)
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6500
STUART KOSH
Social Worker
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (209) 843-0285
HOMAYUN SALEH
Physician Assistant
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6701
TOBY EVANS
Community Health Worker
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6500
JASMINE HARDISON
Day Training/Habilitation Specialist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6740
SVETLANA LESOVA LMFT
Marriage & Family Therapist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-5009
MS. MARIANA TORRES M.S.W.
Social Worker (Clinical)
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6740
KATELYN TSUKAMAKI
Marriage & Family Therapist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6905

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 Razalyn Nickola's NPI number?

The NPI number for Razalyn Nickola is 1780233650. It was assigned to this individual provider in the NPPES registry on September 4, 2019.

Where is Razalyn Nickola located?

Razalyn Nickola practices at 5325 Broder Blvd, Dublin, CA 94568. The listed phone number is (925) 803-7221.

What is Razalyn Nickola's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Razalyn Nickola enrolled in Medicare?

Yes. Razalyn Nickola is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Razalyn Nickola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Razalyn Nickola reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Razalyn Nickola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Razalyn Nickola was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.