Nicole Thompson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32686 Issued in CA

Practice address

100 Prison Rd
Represa, CA 95671-3000

Phone

(916) 985-8610

NPI assigned

Sep 16, 2014

Last updated

Apr 14, 2022By 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

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.

• Corrections and Rehabilitation-Headquarters

  dba California State Prison-Sacramento

  • Pharmacy
  • Represa, CA
  • NPI 1154953529
  NPD (past)

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1740682228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290002",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956710002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRISON RD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956713000",
            "telephone_number": "916-985-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Sullivan, PSY.D.
• Sam Tun Tan, D.M.D.
• Annalisa Maria Taylor
• Mai Ong Thao
• Desmond Thayer, PSY.D.
• Gregory Carl Tinloy, D.D.S.
• Sonia Elizabeth Uribe
• Ruben Valencia, PSY.D.
• Linda Lee Vanderostyne, L.C.S.W.
• Sheena Varghese, RPH

• Clinical Psychologist in Represa, CA
• Providers in Represa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.