Nicole J Ullom, RADT is a
Community Health Worker based in Grass Valley, California. Nicole J Ullom is licensed to practice in California (license number ) and her current practice location is
900 E Main St Ste 201, Grass Valley, California. She can be reached at her office (for appointments etc.) via phone at
(530) 273-2244.
NPI number for Nicole J Ullom is 1942986344 and her current mailing address is 900 E Main St Ste 201, Grass Valley, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1942986344.
Healthcare Provider's Profile
| Full Name | Nicole J Ullom |
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| Gender | Female |
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| Speciality | Community Health Worker |
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| Location | 900 E Main St Ste 201, Grass Valley, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1942986344
- Provider Enumeration Date: 06/22/2023
- Last Update Date: 01/06/2025
Medical Identifiers
Medical identifiers for Nicole J Ullom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1942986344 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | R1510160623 (California) | Secondary |
| 172V00000X | Community Health Worker | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole J Ullom is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Nicole J Ullom, RADT 900 E Main St Ste 201, Grass Valley, CA 95945-5853 Ph: (530) 273-2244 | Nicole J Ullom, RADT 900 E Main St Ste 201, Grass Valley, CA 95945-5853 Ph: (530) 273-2244 |
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