Nicole Dietrich

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36956 Issued in CA

Practice address

3631 S Harbor Blvd Ste 200
Santa Ana, CA 92704-7936

Phone

(657) 356-6490

NPI assigned

Aug 19, 2024

Last updated

Sep 22, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Western Youth Services

  • Adolescent and Children Mental Health Clinic/Center
  • Anaheim, CA
  • NPI 1770617987
  NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1619709466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 S HARBOR BLVD STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047936",
            "telephone_number": "657-356-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 S HARBOR BLVD STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047936",
            "telephone_number": "657-356-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "36956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Maria Didonato, AA
• Isabel Diego
• Denise Diep, BEHAVIOR TECHNICIAN
• Peter Diep, BEHAVIOR TECHNICIAN
• Vinnie Diep, RBT
• Alisa Suzanne Dietz, M.A., B.C.B.A.
• Ruth Dignadice, RN
• Alyssa Dilauro, PT, DPT
• Alison Dilbeck
• Dilshad Medical Inc (Dilshad Concierge Medicine Beverly Hills)

• Clinical Psychologist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.