Dwayne Nickerson
NPI 1780011437 · Marriage & Family Therapist · Riverside, CA
Enrolled with Medicare as Practitioner - Marriage and Family Therapist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1780011437
- Entity type
- Individual
- Primary specialty
- Marriage & Family TherapistBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- LMFT96210 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Marriage & Family Therapist106H00000X
Behavioral Health & Social Service Providers
- Rehabilitation Practitioner225400000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
5 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (4)
- 3787 S Vermont AveLos Angeles, CA 90007-4203Phone: (323) 766-2345
- 301 S Miller St Ste 121Santa Maria, CA 93454Phone: (310) 897-0140
- 301 S Miller St Ste 112Santa Maria, CA 93454Phone: (805) 361-0118Fax: (805) 332-3057
- 301 S Miller St Ste 112Santa Maria, CA 93454Phone: (805) 361-0118Fax: (805) 332-3057
Registry dates
- Enumerated
- 2013-09-26
- Last updated
- 2023-12-21
- Certified
- 2023-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.