Nicole Phillips Connolly, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY23260 Issued in CA

Practice address

25050 Peachland Ave
Suite 250
Santa Clarita, CA 91321-2523

Phone

(661) 430-9300

NPI assigned

Jun 25, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 3, 2023 through Jul 3, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nicole Connolly PH.D., Psychologist, a Professional Corporation

  • Clinical Psychologist
  • Newhall, CA
  • NPI 1659074623
  NPD Authorized official

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1245436369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25050 PEACHLAND AVE",
            "address_2": "SUITE 250",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212523",
            "telephone_number": "661-430-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25050 PEACHLAND AVE",
            "address_2": "SUITE 250",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212523",
            "telephone_number": "661-430-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "NICOLE",
        "middle_name": "PHILLIPS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY23260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Hospice Care Inc
• Compass-Nemt LLC
• Compassionate Healthcare Nursing Associates, Inc.
• Alicia Dawn Conklin, MPT
• Rosemary E Conner, MPT, SCS, ATC, CSCS
• Thomas James Connolly, M.D.
• Alienore Conrad, D.C.
• Consumerhealth, Inc.
• Consumerhealth, Inc. (Newport Dental - Santa Clarita (ORTHO))
• Contemporary Foot and Ankle PC

• Psychologist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.