Nichole Janelle McKenzie, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27389 Issued in CA

Practice address

100 N Barranca St Ste 130
West Covina, CA 91791-1637

Phone

(626) 433-1311

NPI assigned

Jan 19, 2007

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  Medicare reassignment NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Glendora, CA
  • NPI 1710644232
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • West Covina, CA
  • NPI 1952069429
  NPD

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1336292820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470064",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900479564",
            "telephone_number": "213-219-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 130",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911637",
            "telephone_number": "626-433-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1517 W Garvey Ave N",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902138",
            "country_code": "US",
            "telephone_number": "626-962-6061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9864 Baldwin Pl",
            "address_purpose": "LOCATION",
            "city": "El Monte",
            "state": "CA",
            "postal_code": "917312202",
            "country_code": "US",
            "telephone_number": "626-433-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "NICHOLE",
        "middle_name": "JANELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S McDaniels, NP
• Gary McDowell
• Daisy McElfresh
• Pamela Theresa McFarland
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• Austin McLeod
• Guilherme Medeiros
• Medical Support Los Angeles a Medical Corporation
• Medigo Transit Nemt Inc
• Brenda N Medina-Claudio, MSW

• Clinical Psychologist in West Covina, CA
• Providers in West Covina, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.