| Nicole M Rose, LCSW | |
|
7264 Olympic Rd Apt 102, Joshua Tree, CA 92252-2787 | |
| (760) 565-2325 | |
| Not Available |
| Full Name | Nicole M Rose |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 7264 Olympic Rd Apt 102, Joshua Tree, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518367952 | NPI | - | NPPES |
| #95-2633765 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 106566 (California) | Primary |
| Entity Name | Affiliated Psychological Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750384350 PECOS PAC ID: 3779561378 Enrollment ID: O20040826001246 |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole M Rose, LCSW 56925 Yucca Valley Trail, Pmb 513, Yucca Valley, CA 92284 Ph: (760) 910-5488 | Nicole M Rose, LCSW 7264 Olympic Rd Apt 102, Joshua Tree, CA 92252-2787 Ph: (760) 565-2325 |
Haylie Cole, MSW, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6162 Rotary Way, Joshua Tree, CA 92252 Phone: 760-366-3791 | |
Heather Marshall, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 1441, Joshua Tree, CA 92252 Phone: 111-111-1111 |