John Thomas Nickens, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14670 Issued in CA

Practice address

465 34TH St
Oakland, CA 94609-2815

Phone

(510) 287-9456

Fax

(519) 382-9716

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Peter Oppermann PHD Psychology Prof. Corp.

  • Clinical Psychologist
  • Concord, CA
  • NPI 1881182905
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427115542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465-34TH STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-287-9456",
            "fax_number": "510-382-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 34TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092815",
            "telephone_number": "510-287-9456",
            "fax_number": "519-382-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKENS",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea S Nicholas, PT
• Czar Nicholas
• D. Jeanette Nichols
• Scott Lee Nickell, MSN, FNP
• Esther Yoon Nickelson, FNP-C
• Lena Nicodemus, MA, LMFT
• Natasha L Nicolai, DPT
• Arrian Tolentino Nicolas
• Heidi Gayle Nicoll-Merson, MD
• Anna S Nidhiry, DO

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.