Individual provider Active NPI

Simret Nanda

  • Psychiatry Physician
  • Porterville, CA
National Provider Identifier
1457518425
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A106232 Issued in CA
Practice address
1055 W Henderson Ave Ste 2
Porterville, CA 93257-1490
Phone
(888) 774-6443
NPI assigned
May 19, 2008
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 239254 NY
Psychiatry Physician 2084P0800X A106232 CA Primary

Addresses

Primary practice location

1055 W Henderson Ave Ste 2
Porterville, CA 93257-1490

Mailing address

2950 Camino Diablo Ste 120
Walnut Creek, CA 94597-3979
Phone (925) 388-6785

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091116000260 CA Practitioner - Psychiatry 2365517554 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106232CAMDDentist
A106232CAMDPsychiatry Physician
239254NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Mar 6, 2019 Accepting new patients
County of Humboldt CurrentSince Sep 19, 2015 Accepting new patients
County of Humboldt CurrentSince Sep 19, 2015 Accepting new patients
County of Humboldt Current Accepting new patients
Park Slope Center for Mental Health, Inc PastSince Oct 11, 2005 Accepting new patients

Locations

720 Wood St
Eureka, CA 95501
Phone (707) 268-2900

2523 El Portal Dr
Ste 103
San Pablo, CA 94806
Phone (510) 215-3730

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1457518425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CAMINO DIABLO STE 120",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973979",
            "telephone_number": "925-388-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 W HENDERSON AVE STE 2",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571490",
            "telephone_number": "888-774-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDA",
        "first_name": "SIMRET",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "239254",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.