Active NPI
Nicole L Witherspoon, PSY.D.
- Psychologist
- San Diego, CA
National Provider Identifier
1346757531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36380
- Practice address
- 2635 Camino del Rio S Ste 104
San Diego, CA 92108-3727 - Phone
- (858) 869-3100
- NPI assigned
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-38545 | CA | |
| Psychologist | 103T00000X | 36380 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2635 Camino del Rio S Ste 104
San Diego, CA 92108-3727
Mailing address
2635 Camino del Rio S Ste 104
San Diego, CA 92108-3727
Phone (858) 869-3100
Other names 1
- Nicole Leanne Nelson
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-38545 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients | |
| Community Research Foundation Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba New Vistas
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1346463932
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1346757531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2635 CAMINO DEL RIO S STE 104",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083727",
"telephone_number": "858-869-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2635 CAMINO DEL RIO S STE 104",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083727",
"telephone_number": "858-869-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERSPOON",
"first_name": "NICOLE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-38545",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "36380",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "NELSON",
"middle_name": "LEANNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.