Nicole Taylor, PH.D., J.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3821 Issued in AZ

Practice address

321 N. Bailey Street
#D
Florence, AZ 85132

Phone

(480) 510-5549

NPI assigned

Jul 27, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Wagstaff Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Philosophy

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1184938524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E HUNT HWY",
            "address_2": "STE. 103-250",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851436581",
            "telephone_number": "480-510-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N. BAILEY STREET",
            "address_2": "#D",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "85132",
            "telephone_number": "480-510-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PH.D., J.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WAGSTAFF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Florence, AZ
• Providers in Florence, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.