Active NPI
Alexis Piciucco
- Clinical Psychologist
- Sacramento, CA
National Provider Identifier
1376009068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 30739
- Practice address
- 9700 Business Park Dr Ste 207
Sacramento, CA 95827-1717 - Phone
- (916) 361-7188
- NPI assigned
- Feb 18, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 30739 | CA | Primary |
Addresses
Primary practice location
9700 Business Park Dr Ste 207
Sacramento, CA 95827-1717
Mailing address
9700 Business Park Dr Ste 207
Sacramento, CA 95827-1717
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190523000520 | CA | Practitioner - Clinical Psychologist | 6204179815 | Practice locations: Sacramento, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9700 Business Park Dr
Suite 207
Sacramento, CA 95827-1717
Phone (916) 361-7188
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30739 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luigi Piciucco PHD Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Sacramento, CA
- NPI 1386833911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1376009068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9700 BUSINESS PARK DR STE 207",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958271717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9700 BUSINESS PARK DR STE 207",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958271717",
"telephone_number": "916-361-7188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICIUCCO",
"first_name": "ALEXIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-18",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "30739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.