MEDICARE: NICOLE DANIELLE WIDMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	120505	CA

General Provider Information

NPI Number	:	1972179828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE DANIELLE WIDMAN LCSW

Provider Business Mailing Address
First Line	:	3857 BIRCH ST # 9105
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	34248 VIA SANTA ROSA
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92624-1121
Country	:	US
Telephone Number	:	844-268-8412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	03/02/2026

Similar Medicare Providers

1043442346 — PACIFIC HILLS TREATMENT CENTERS, INC.
Practice Location Address:

34248 VIA SANTA ROSA
CAPISTRANO BEACH, CA
92624-1121

Practice Phone: 949-489-8121
Practice Fax: 949-489-8135

1093252207 — JAMES SHOFFEITT
Practice Location Address:

34244 VIA SANTA ROSA , SUITE A
CAPISTRANO BEACH, CA
92624-1121

Practice Phone: 760-625-4320
Practice Fax:

1639131865 — MRS. OKSANA V BUBLIK DDS
Practice Location Address:

26893 CALLE HERMOSA
DANA POINT, CA
92624-1635

Practice Phone: 949-503-3430
Practice Fax: 949-503-3431

1619998879 — AMERICAN RESPIRATORY THERAPY SERVICES
Practice Location Address:

26841 CALLE HERMOSA , SUITE D
DANA POINT, CA
92624-1635

Practice Phone: 949-492-7240
Practice Fax: 949-366-9721

1508961863 — MRS. ARLENE KLEIN UNGER PHD
Practice Location Address:

34231 CAMINO CAPISTRANO , #213
DANA POINT, CA
92624-1156

Practice Phone: 949-240-7302
Practice Fax: 949-218-7609

1275725897 — NATHAN THOMAS GILMORE MD
Practice Location Address:

35410 DEL REY
DANA POINT, CA
92624-1814

Practice Phone: 801-330-9242
Practice Fax:

Directions to “ NICOLE DANIELLE WIDMAN LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.