Nisreen Sadiq Mandilawi, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 24745 Issued in CA

Practice address

25 Cadillac Dr Ste 104
Sacramento, CA 95825-8350

Phone

(916) 919-8066

Fax

(916) 919-8066

NPI assigned

Jul 20, 2009

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1639309016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CADILLAC DR STE 104",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258350",
            "telephone_number": "916-919-8066",
            "fax_number": "916-919-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CADILLAC DR STE 104",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258350",
            "telephone_number": "916-919-8066",
            "fax_number": "916-919-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDILAWI",
        "first_name": "NISREEN",
        "middle_name": "SADIQ",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aneel Mandava, M.D.
• Daniel A. Mandel
• Gilbert L. Mandell, M.D.
• Justin Abraham Mandell, MD
• Natalie Mandeville
• Nancy Carol Mandler, N.P., R.N., MSN
• Stephen Lawrence Maney
• Josef Michael Mang
• Gladys Mangabat, LVN
• Norminio Mangabat

• Psychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.