Individual provider Active NPI

Thalia Pitsillidou Sullivan Nicholson, PHD

  • Psychologist
  • Auburn, CA
National Provider Identifier
1760053136
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35995 Issued in CA
Practice address
140 Pine St
Auburn, CA 95603-5247
Phone
(530) 423-3714
NPI assigned
Jul 7, 2021
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35995 CA Primary
Psychologist 103T00000X 1300 NV

Addresses

Primary practice location

140 Pine St
Auburn, CA 95603-5247

Mailing address

5701 Lonetree Blvd Ste 113
Rocklin, CA 95765-3792
Phone (530) 423-3714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 17, 2026 through Feb 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1300NVMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thalia Nicholson Psychological Services, Inc. CurrentSince Nov 24, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1760053136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 LONETREE BLVD STE 113",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653792",
            "telephone_number": "530-423-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PINE ST",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956035247",
            "telephone_number": "530-423-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN NICHOLSON",
        "first_name": "THALIA",
        "middle_name": "PITSILLIDOU",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "35995",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "1300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.