NICOLAS LUIS MEDELLIN NPI 1558229955

NPI Information

  • NPI: 1558229955
  • Provider Name: NICOLAS LUIS MEDELLIN
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 18985 HIGHWAY 94
    DULZURA, CA
    ZIP 91917
  • Phone: (619) 335-2994

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NPI Details

Nicolas Luis Medellin is an addiction (substance use disorder) counselor in Dulzura, CA. Nicolas Luis Medellin NPI is 1558229955. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18985 HIGHWAY 94
DULZURA, CA
ZIP 91917-527
Phone: (619) 335-2994

The enumeration date for this NPI number is 1/13/2026 and was last updated on 1/13/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)RT1424991225CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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