Thalia Pitsillidou Sullivan Nicholson, PHD
Individual provider Active NPI Psychologist · Auburn, CA
NPI 1760053136 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1760053136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 35995 (CA)
- Practice address
- 140 Pine St
Auburn, CA 95603-5247 - Phone
- (530) 423-3714
- NPI assigned
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- 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
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1300 | NV | MD | Psychologist |
| 35995 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thalia Nicholson Psychological Services, Inc. | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35995 | CA | Yes |
| 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
Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.