Active NPI
Alexandra Nichols, PHD
- Clinical Psychologist
- Corte Madera, CA
National Provider Identifier
1023465259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY32515
- Practice address
- 100 Meadowcreek Dr Ste 115
Corte Madera, CA 94925-1230 - Phone
- (415) 843-1523
- NPI assigned
- May 17, 2016
- Last updated
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY32515 | CA | Primary |
Addresses
Primary practice location
100 Meadowcreek Dr Ste 115
Corte Madera, CA 94925-1230
Mailing address
PO Box 2854
Santa Rosa, CA 95405-0854
Phone (707) 536-1856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY32515 | CA | MD | Clinical Psychologist |
| 32515 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1023465259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2854",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954050854",
"telephone_number": "707-536-1856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEADOWCREEK DR STE 115",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251230",
"telephone_number": "415-843-1523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "ALEXANDRA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-17",
"last_updated": "2021-06-30",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY32515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
- Mvjbp Physical Therapy Corporation (Mill Valley Physical Therapy)
- Farbod Nadjibi, DDS
- Deborah Riva Nelson, PHD, MFT
- Donald B Nevins, M.D.
- Michelle Dieu Tram Nguyen, OTR/L
- Susan Mary Nickerson
- Summer Nipomnick, PHD
- Nordstrom Inc & Subsidiaries
- North Bay Internal Medicine and Pediatrics
- North Bay Surgical Group
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.