Individual provider Active NPI

Nicole Amin Delpasand, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ventura, CA
National Provider Identifier
1558901967
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95016179 Issued in CA
Practice address
1752 S Victoria Ave Ste 250
Ventura, CA 93003-6152
Phone
(805) 650-3880
NPI assigned
Jan 14, 2020
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95016179 CA Primary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X 95130440 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 845059 NV

Addresses

Primary practice location

1752 S Victoria Ave Ste 250
Ventura, CA 93003-6152

Mailing address

PO Box 941305
Simi Valley, CA 93094-1305

Other practice location 1

173 Laurel Ridge Dr
Simi Valley, CA 93065-8212
Phone (805) 551-8854

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL none

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220127001266 CA Practitioner - Nurse Practitioner 4587056387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

2029 Century Park E
Suite 400 Office 478
Los Angeles, CA 90067-2957
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95016179CAMDPsychiatric/Mental Health Nurse Practitioner
845059NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee D. Mendiola MD PC Single Specialty PastSince Mar 21, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nicole.delpasand.1@9357.direct.athenahealth.com

Organizations & group practices 2

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1558901967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 941305",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930941305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 S VICTORIA AVE STE 250",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036152",
            "telephone_number": "805-650-3880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Laurel Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930658212",
            "country_code": "US",
            "telephone_number": "805-551-8854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELPASAND",
        "first_name": "NICOLE",
        "middle_name": "AMIN",
        "name_prefix": "Miss",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95016179",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95130440",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "845059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "173 Laurel Ridge Dr",
            "city": "Simi Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930658212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.