Joy G. Nichols, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY20567 Issued in CA

Practice address

2195 Club Center Dr Ste a
San Bernardino, CA 92408-4162

Phone

(909) 651-1899

Fax

(909) 558-3809

NPI assigned

Nov 27, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

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  Medicare reassignment NPD
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  • Pediatrics Physician
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  NPD

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528134186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "PO BOX 33932",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711303932",
            "telephone_number": "318-675-4783",
            "fax_number": "318-675-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 CLUB CENTER DR STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084162",
            "telephone_number": "909-651-1899",
            "fax_number": "909-558-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY20567",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "LA",
            "license": "1062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trung D Nguyen, MD
• Van T Nguyen, PHARM D.
• Vinh Tran Nguyen, MD
• William Phat Nguyen, PHARM D
• Duane Nichols
• Peter John Niciforos, M.D.
• Maria Nicolaou
• Anthony Joseph Nieto
• Afrouz Nikmanesh
• Daniel Ninan, D.D.S.

• Clinical Neuropsychologist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.