Nicolle Andreea Pacifico, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29488 Issued in CA

Practice address

4300 Rose Dr
Yorba Linda, CA 92886-2026

Phone

(714) 528-4211

NPI assigned

Sep 7, 2017

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

Other names 1

• Nicolle Andreea Bugescu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624

  Multi-Specialty

  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1740708098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 ROSE DR",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862026",
            "telephone_number": "714-528-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 ROSE DR",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862026",
            "telephone_number": "714-528-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIFICO",
        "first_name": "NICOLLE",
        "middle_name": "ANDREEA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLLE",
            "last_name": "BUGESCU",
            "middle_name": "ANDREEA",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krisztina Juhasz Osso, PT
• Ouch Enterprises
• Deanna Ozenbaugh, LMFT
• Amber Lynn Pachon, M.D.
• Pacific Partners Optometric Group Inc
• Alfonso Joshua Padilla
• Dariya Pak, FNP
• Erika Pallares
• Billie K Park, D.O.
• James Myeng Park

• Clinical Psychologist in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.