Provider Demographics
NPI:1356002810
Name:RUPP, NICOLE CHRISTINE (LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:RUPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 PLACER ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1152
Mailing Address - Country:US
Mailing Address - Phone:530-395-1925
Mailing Address - Fax:
Practice Address - Street 1:1177 PLACER ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1152
Practice Address - Country:US
Practice Address - Phone:530-395-1925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1329531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical