Healthcare Provider Details

I. General information

NPI: 1396524443
Provider Name (Legal Business Name): NICHOLAS WARNER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27648 SUSAN BETH WAY UNIT H
SANTA CLARITA CA
91350-1792
US

IV. Provider business mailing address

24355 CREEKSIDE RD PO BOX 801043
SANTA CLARITA CA
91380-7000
US

V. Phone/Fax

Practice location:
  • Phone: 661-270-6242
  • Fax:
Mailing address:
  • Phone: 661-270-6242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW136538
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: