Active NPI
Nicole Prause, PHD
- Psychologist
- Los Angeles, CA
National Provider Identifier
1356963037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 27778
- Practice address
- 4650 W Sunset Blvd FL 8
Los Angeles, CA 90027-6062 - Phone
- (323) 919-0783
- NPI assigned
- May 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 27778 | CA | Primary |
Addresses
Primary practice location
4650 W Sunset Blvd FL 8
Los Angeles, CA 90027-6062
Mailing address
PO Box 1318
Sacramento, CA 95812-1318
Phone (323) 919-0783
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1356963037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1318",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958121318",
"telephone_number": "323-919-0783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD FL 8",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062",
"telephone_number": "323-919-0783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAUSE",
"first_name": "NICOLE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-15",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "27778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.