NICOLE G. MEDINA
NPI 1801548250
Marriage & Family Therapist in Tustin, CA

Q: What is Nicole Medina's NPI number?

The NPI number for Nicole Medina is 1801548250. It was assigned to this individual provider in the NPPES registry on January 26, 2022.

Q: What is Nicole Medina's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Medina was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.

Active since January 26, 2022PECOS Enrolled

250 EL CAMINO REAL STE 213, TUSTIN, CA 92780(714) 805-6510 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 18, 2024, Jan 26, 2022 (2 updates tracked since 2022).

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About Nicole G. Medina NPPES

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

NICOLE G. MEDINA (NPI 1801548250) is an individual marriage & family therapist in Tustin, California, licensed in California (135401) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1801548250

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameNICOLE G. MEDINA

Location Address250 EL CAMINO REAL STE 213Tustin, CA 92780-3656

Mailing Address1751 Colorado Blvd # 180Los Angeles, CA 90041-1348 · (213) 379-5371

Phone(714) 805-6510

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 26, 2022

Last NPPES UpdateSeptember 18, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 18, 2024

✔ NPI 1801548250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 135401

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

250 EL CAMINO REAL STE 213, Tustin, CA 92780

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

PECOS PAC ID840774378

PECOS Enrollment IDI20260323001150

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.

Other Providers at the Same Location NPPES 16

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

BRYAN PATRICK HARTZELL

Marriage & Family Therapist