Kyle Nixon, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30919 Issued in CA

Practice address

12530 10TH St Ste C
Chino, CA 91710-3520

Phone

(909) 248-3434

Fax

(909) 614-7870

NPI assigned

Sep 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2023 through Jan 1, 2027

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 and National Provider Directory roles.

• Nixon Psychological Institute, Inc.

  • Clinical Psychologist
  • Chino, CA
  • NPI 1548958515
  NPD Authorized official
• Autism Behavior Centers Inc

  • Behavior Analyst
  • Chino, CA
  • NPI 1689447989

  Single Specialty

  NPD

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1609395672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12530 10TH ST STE C",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103520",
            "telephone_number": "909-248-3434",
            "fax_number": "909-614-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12530 10TH ST STE C",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103520",
            "telephone_number": "909-248-3434",
            "fax_number": "909-614-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIXON",
        "first_name": "KYLE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSY30919",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scarlett Dongduy Nguyen, O.MD;LAC
• Vance T Nguyen, O.D
• Erin Nichiporuk
• John Edward Nigbor, PSYD
• Nixon Psychological Institute, Inc.
• Shienan Nixon
• NKS Pharmacy
• No Place Like Home Health Care, LLC
• Celerina Noreik, FNP
• Randall Stewat Norris, PH.D.

• Clinical Psychologist in Chino, CA
• Providers in Chino, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.