Active NPI
Ellen Elizabeth Nichols, PSYD
- Psychologist
- Camarillo, CA
National Provider Identifier
1598280224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSB94022807
- Practice address
- 360 Mobil Ave Ste K
Camarillo, CA 93010-6325 - Phone
- (818) 584-4728
- Fax
- (818) 706-8684
- NPI assigned
- Aug 3, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSB94022807 | CA | Primary |
Addresses
Primary practice location
360 Mobil Ave Ste K
Camarillo, CA 93010-6325
Mailing address
1860 Falling Star Ave
Westlake Village, CA 91362-5277
Phone (818) 522-3810
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 |
|---|---|---|---|
| PSB94022807 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501718400000",
"number": "1598280224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 FALLING STAR AVE",
"city": "WESTLAKE VILLAGE",
"state": "CA",
"postal_code": "913625277",
"telephone_number": "818-522-3810",
"fax_number": "818-706-8684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 MOBIL AVE STE K",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930106325",
"telephone_number": "818-584-4728",
"fax_number": "818-706-8684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "ELLEN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-03",
"last_updated": "2017-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSB94022807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.