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

Raevin Nickerson, RAD-T

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1487438594

Raevin Nickerson, RAD-T is an Addiction (Substance Use Disorder) Counselor in Fairfield, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023

Practice location Address checks out

1225 Travis Blvd
Fairfield, CA 94533-4892
Phone: (707) 399-9105
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence R1521270823 (CA)

Record details

NPI number1487438594
Entity typeIndividual (Type 1)
GenderFemale
Credentials RAD-T
Sole proprietorNo
NPI enumeratedAugust 21, 2023
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023
Mailing address609 Jefferson St, Fairfield, CA 94533-6293

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