Active NPI
Nicole Renee Vincent, PH.D.
- Health Service Psychologist
- Orange, CA
National Provider Identifier
1437228970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- PSY 16341
- Practice address
- 455 S Main St
Choc - Department of Pediatric Psychology
Orange, CA 92868-3835 - Phone
- (714) 532-8483
- Fax
- (714) 532-8756
- NPI assigned
- Nov 7, 2006
- 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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | PSY 16341 | CA | Primary |
Addresses
Primary practice location
455 S Main St
Choc - Department of Pediatric Psychology
Orange, CA 92868-3835
Mailing address
455 S Main St
Choc - Department of Pediatric Psychology
Orange, CA 92868-3835
Phone (714) 532-8483
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 16341 | CA | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437228970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 S MAIN ST",
"address_2": "CHOC - DEPARTMENT OF PEDIATRIC PSYCHOLOGY",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683835",
"telephone_number": "714-532-8483",
"fax_number": "714-532-8756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 S MAIN ST",
"address_2": "CHOC - DEPARTMENT OF PEDIATRIC PSYCHOLOGY",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683835",
"telephone_number": "714-532-8483",
"fax_number": "714-532-8756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "NICOLE",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "CA",
"license": "PSY 16341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.