Dr. Nicole Chavez Psychological Services P.C.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Legal business name

DR. NICOLE CHAVEZ PSYCHOLOGICAL SERVICES P.C.

Practice address

427 E 17TH St # STF-1112
Costa Mesa, CA 92627-3201

Phone

(949) 280-4685

NPI assigned

May 21, 2022

Last updated

May 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Chavez, PSY.D.NPI 1881888733

Title

Ceo

Phone

(949) 280-4685

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Renee Chavez, PSY.D.

  • Psychologist
  • Irvine, CA
  • NPI 1881888733
  NPD Authorized official

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653091200000",
    "number": "1174261051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 MESA VERDE DR E APT 40K",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265246",
            "telephone_number": "949-280-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 E 17TH ST # STF-1112",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273201",
            "telephone_number": "949-280-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NICOLE CHAVEZ PSYCHOLOGICAL SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-280-4685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.