Individual provider Active NPI

Alicia Cisneros, PPS

  • School Psychologist
  • Richmond, CA
National Provider Identifier
1790490266
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
210155114 Issued in CA
Practice address
1108 Bissell Ave
Richmond, CA 94801-3135
Phone
(510) 307-4506
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TS0200X 210155114 CA Primary

Addresses

Primary practice location

1108 Bissell Ave
Richmond, CA 94801-3135

Mailing address

1108 Bissell Ave
Richmond, CA 94801-3135
Phone (510) 307-4506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
210155114CAMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1790490266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 BISSELL AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013135",
            "telephone_number": "510-307-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 BISSELL AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013135",
            "telephone_number": "510-307-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "ALICIA",
        "credential": "PPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "210155114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.