Nichole Lynn Mogharreban, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30199 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305

Phone

(650) 723-4000

NPI assigned

Jun 22, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

88.53 of 100Reported as group

Quality

87.08

Promoting interoperability

100

Improvement activities

40

Cost

69.51

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1013270180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Jackson Ave Madigan Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-2252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOGHARREBAN",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30199",
            "primary": true
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": "CA",
            "license": "PSY30199",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY30199",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60446879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alimohammad Seyed Moalem, MD
• Mehrdad Mobasher, MD MPH
• James Paul Mobley, NP
• Rahul Hasmukh Modi, MD
• Everett James Moding, MD
• Arazue Nicolette Moghtaderizadeh, PA-C
• Paul K Mohabir, M.D.
• Maha Abdalla Mohamed, MD
• Irfan Mohammed, PA-C
• Shalini Mohan, M.D.

• Clinical Psychologist in Stanford, CA
• Providers in Stanford, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.