Nicole Ryan Humphreys, LCSW
Social Worker, Clinical in Patton, CA. Individual provider (NPI-1).
NPI number1154516052
StatusActive
Last updated in NPPESNov 17, 2016
Details
- NPI
- 1154516052
- Entity type
- Individual (NPI-1)
- Name
- Nicole Ryan Humphreys
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 13, 2007
- Last updated
- Nov 17, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCSW29557 | CA | Yes |
| 1041S0200X | Social Worker, School | – | – |
Other names
- Nicole Ryan Hunt (Former Name)
Practice location
3102 E. Highland AvenueMedical Staff Office
Patton, CA 92369
Phone 909-425-7000
Mailing address
3102 E. Highland AvenueMedical Staff Office
Patton, CA 92369
Phone 909-425-7000
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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