Active NPI
Nicole Cheung, PSY.D
- Clinical Psychologist
- Menlo Park, CA
National Provider Identifier
1477054823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 29538
- Practice address
- 845 El Camino Real
Menlo Park, CA 94025-4807 - Phone
- (415) 621-9503
- NPI assigned
- Feb 21, 2018
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 29538 | CA | Primary |
Addresses
Primary practice location
845 El Camino Real
Menlo Park, CA 94025-4807
Mailing address
535 Easterby St
Sausalito, CA 94965-1710
Phone (617) 335-7254
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29538 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519171200000",
"number": "1477054823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 EASTERBY ST",
"city": "SAUSALITO",
"state": "CA",
"postal_code": "949651710",
"telephone_number": "617-335-7254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 EL CAMINO REAL",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254807",
"telephone_number": "415-621-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEUNG",
"first_name": "NICOLE",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2018-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.