Nida Mirza, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28205 Issued in CA

Practice address

4 Orinda Way Ste 250B
Orinda, CA 94563-2536

Phone

(415) 843-1523

NPI assigned

Jun 27, 2011

Last updated

Jan 3, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carson Center for Human Services, Inc.

  • Community/Behavioral Health Agency
  • Westfield, MA
  • NPI 1457385460
  NPD (past)
• The Carson Center

  • Public Health or Welfare Agency
  • Westfield, MA
  • NPI 1215975842
  NPD (past)

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1346536430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 COLE ST # 368",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941174316",
            "telephone_number": "415-843-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ORINDA WAY STE 250B",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632536",
            "telephone_number": "415-843-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "NIDA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@theclinicca.org",
            "affiliation": "N",
            "address_1": "4 Orinda Way Ste 250B",
            "city": "Orinda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945632536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marites Milan
• Hannah Maryellen Miller, AMFT
• Mary Lynn Miller, M.D.
• Min-Jeong Kim DDS Ms Inc
• Seyed Hadi Mirhedayati Roudsari, MD
• Tanya Mitchnick, DC
• Mojgan Mehranfard, DDS, Inc. (Orinda Dental Care)
• Laura Mooney, MSW
• Danielle Nicole Morales, LEP
• Rachel English Moran, MA, LMFT

• Clinical Psychologist in Orinda, CA
• Providers in Orinda, 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 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.