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Export Provider Record NPI 1053560573
Molly Beth NickersonMSW, ACSW
Active
NPI Number1053560573
NPI TypeNPI-1 Individual
SpecialtyRehabilitation Practitioner
Provider Details
NPI1053560573
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2008-09-09
Last Updated2017-01-19
Mailing Address601 S Prospect Ave, Unit 306
Redondo Beach, CA 90277-4456
United States
Phone: (310) 793-6360
📍 View Map
Primary Practice Address923 S Catalina Ave
Redondo Beach, CA 90277-4718
United States
Phone: (310) 792-5454 | Fax: (310) 792-5463
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCA1053560573
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes225400000X – Rehabilitation Practitioner
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About NPI 1053560573

Molly Beth Nickerson MSW, ACSW is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053560573. The primary specialty listed is Rehabilitation Practitioner. The provider is located in Redondo Beach, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-09-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053560573?

NPI 1053560573 belongs to Molly Beth Nickerson MSW, ACSW, a Rehabilitation Practitioner in Redondo Beach, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053560573 active?

The current status of NPI 1053560573 in the NPPES registry is Active. The record was last updated on 2017-01-19.

What specialty is NPI 1053560573?

NPI 1053560573 is classified under the taxonomy Rehabilitation Practitioner. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053560573?

You can verify NPI 1053560573 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053560573?

The primary practice address on file for NPI 1053560573 is 923 S Catalina Ave, Redondo Beach, CA 90277-4718. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053560573 issued?

NPI 1053560573 was first issued (enumerated) on 2008-09-09. The NPPES record was last updated on 2017-01-19.

Practice Location Map

Molly Beth Nickerson is located at 923 S Catalina Ave, Redondo Beach, CA. Use the map below to find directions or verify the practice location.

📍 923 S Catalina Ave, Redondo Beach, CA 90277-4718  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Molly Beth Nickerson. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-15 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162