Nicholas John Pollizzi

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

License

103K00000X Issued in CA

Practice address

4438 Buckeye Way
Antioch, CA 94531-9334

Phone

(925) 755-8499

Fax

(925) 755-8495

NPI assigned

Aug 23, 2024

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

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.

• The Lighthouse Mentoring Center

  • Mental Illness Community Based Residential Treatment Facility
  • Antioch, CA
  • NPI 1932774692
  NPD (past)

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1760215701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 J ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164218",
            "telephone_number": "916-250-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 BUCKEYE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319334",
            "telephone_number": "925-755-8499",
            "fax_number": "925-755-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLIZZI",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-23",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": "103K00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Pineda
• Tiera Marshae Pinkston
• Planned Parenthood Shasta Diablo Inc
• Catherine Mary Pluta, NURSE PRACTITIONER
• Phillip Willie Tan Polido, M.D
• Alexzander Ponce
• Daetra Ponnell
• Eric Kin Poon, M.D.
• Samira Poorhadi
• Amber Porras

• Day Training/Habilitation Specialist in Antioch, CA
• Providers in Antioch, CA by specialty
• Day Training/Habilitation Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.