Provider Demographics
NPI:1235542861
Name:SIEWELL, NICHOLAS BRANDON (ASW)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:BRANDON
Last Name:SIEWELL
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 STOCKDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2153
Mailing Address - Country:US
Mailing Address - Phone:661-322-1021
Mailing Address - Fax:661-322-7074
Practice Address - Street 1:3628 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2153
Practice Address - Country:US
Practice Address - Phone:661-322-1021
Practice Address - Fax:661-322-7074
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW769071041C0700X
CAASW636391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical