Individual provider Active NPI

Matthew Nozaki, PHD

  • Psychologist
  • Newport Beach, CA
National Provider Identifier
1386251122
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY35140 Issued in CA
Practice address
4740 Von Karman Ave Ste 120
Newport Beach, CA 92660-2172
Phone
(949) 342-4281
NPI assigned
Sep 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY35140 CA Primary

Addresses

Primary practice location

4740 Von Karman Ave Ste 120
Newport Beach, CA 92660-2172

Mailing address

4740 Von Karman Ave Ste 120
Newport Beach, CA 92660-2172
Phone (949) 342-4281

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731003735 CA Practitioner - Clinical Psychologist 4981141587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Psychological Services PCGroup PAC ID 1759640816, 5 clinicians

Practice addresses (Care Compare)

4740 Von Karman Ave
Suite 120
Newport Beach, CA 92660-2172
Phone (949) 910-3197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY35140CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Psychological Services, P.C. CurrentSince Jul 1, 2024 Accepting new patients

Locations

23 Corporate Plaza Dr
Ste 150
Newport Beach, CA 92660
Phone (949) 329-3733

4740 Von Karman Ave
Ste 120
Newport Beach, CA 92660
Phone (949) 910-3197

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.

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1386251122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 VON KARMAN AVE STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602172",
            "telephone_number": "949-342-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 VON KARMAN AVE STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602172",
            "telephone_number": "949-342-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZAKI",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY35140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.