Nicole Smith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31458 Issued in CA

Practice address

777 Davis St
San Leandro, CA 94577-6923

Phone

(510) 626-2800

NPI assigned

Jul 11, 2011

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1689962706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776923",
            "telephone_number": "510-626-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776923",
            "telephone_number": "510-626-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catilla Smith
• Chelsea Smith, COTA/L
• Harriet C. Smith, MD
• Kevin Smith, CRNA
• Laura Elena Smith, MS
• Paul Smith
• Sarah Margaret Smith, LCSW
• Shannon S Smith
• Susan Smith
• Tracie Maria Smith

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.