Individual provider Active NPI

Nicole Leona Preiss, PSYD

  • Psychologist
  • Tracy, CA
National Provider Identifier
1235508656
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY27315 Issued in CA
Practice address
2185 W Grant Line Rd
Psychiatry
Tracy, CA 95377-7309
Phone
(209) 839-6252
NPI assigned
Sep 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY27315 CA Primary

Addresses

Primary practice location

2185 W Grant Line Rd
Psychiatry
Tracy, CA 95377-7309

Mailing address

2185 W Grant Line Rd
Psychiatry
Tracy, CA 95377-7309
Phone (209) 839-6252

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY27315CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1235508656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 W GRANT LINE RD",
            "address_2": "PSYCHIATRY",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777309",
            "telephone_number": "209-839-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 W GRANT LINE RD",
            "address_2": "PSYCHIATRY",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777309",
            "telephone_number": "209-839-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREISS",
        "first_name": "NICOLE",
        "middle_name": "LEONA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY27315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.