Nicole Lara Sucre, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

23714 Issued in CA

Practice address

1700 Pierce St Ste 103
San Francisco, CA 94115-3187

Phone

(415) 999-3264

Fax

(415) 901-0316

NPI assigned

Sep 3, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  NPD

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1669789194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PIERCE ST STE 103",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153187",
            "telephone_number": "415-999-3264",
            "fax_number": "415-901-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PIERCE ST STE 103",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153187",
            "telephone_number": "415-999-3264",
            "fax_number": "415-901-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCRE",
        "first_name": "NICOLE",
        "middle_name": "LARA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "23714",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "23714",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "23714",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "23714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Substance Use Disorder Services
• Ayaa L Subuh
• Jason Jerome Suchecki
• Ma Del Carmen Suchil Sanabria
• Jacek Suchodolski, M.S.W.
• Victor Sucy
• Rahul Rajendra Sud, O.D.
• Sohil Sud
• Kokoro Suda
• Margaret Ayuko Suda, MSN, RN, PHN, FNP-C

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.