Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Anastasia Spooner, NURSEPRACTITIONER

Individual provider Registered Nurse · NPI 1508186644

Nicole Anastasia Spooner, NURSEPRACTITIONER is a Nurse Practitioner in Berkeley, California. Qualified in 2016, 10 years ago. Practices with Union Square Dermatology a Professional Corporation, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2010
Specialties on file
2
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Practice location Address checks out

1612 Julia St
Berkeley, CA 94703
Phone: (415) 307-4566
Fax: (415) 206-4153
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1450 Treat Blvd # 160, Walnut Creek, CA 94597-2168 — (925) 296-9000

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95005748 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 755783 (CA)

Record details

NPI number1508186644
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJune 10, 2010
Last updated in NPPESJuly 5, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Union Square Dermatology A Professional Corporation — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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