Cory Mikel Nyamora, PSYD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 20441 Issued in CA

Practice address

759 Appian Way Ste 2D
Pinole, CA 94564-2470

Phone

(510) 981-1471

Fax

(844) 630-7783

NPI assigned

Jan 2, 2007

Sex

Male

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 and National Provider Directory roles.

• Endurance- a Sports and Psychology Center, Inc.

  • Clinical Psychologist
  • Berkeley, CA
  • NPI 1184041014
  NPD Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1710044375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958211210",
            "telephone_number": "510-981-1471",
            "fax_number": "844-630-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 APPIAN WAY STE 2D",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642470",
            "telephone_number": "510-981-1471",
            "fax_number": "844-630-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAMORA",
        "first_name": "CORY",
        "middle_name": "MIKEL",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manda Julieanne Notzon, M.D.
• Nova Care
• Nursol Healthcare Services 'Limited Liability Company'
• Laura Nusbaum, M.A.
• Susan Lee Nuttle, D.D.S.
• Daniel J O'Shea
• Nicole Oaks, ATC
• Carina Obrien
• Itati Rubi Ocampo
• Oconnor Physician Group Inc

• Clinical Psychologist in Pinole, CA
• Providers in Pinole, 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 17, 2023; 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.