Sherri Nielsen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 26749 Issued in CA

Practice address

1539 Harbor Ave
Long Beach, CA 90813-1322

Phone

(310) 702-6501

NPI assigned

Oct 28, 2014

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mission City Community Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, CA
  • NPI 1710102009
  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Community Health Clinic/Center
  • North Hills, CA
  • NPI 1710370747
  NPD

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1841695129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 W 18TH ST",
            "address_2": "#2",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314554",
            "telephone_number": "310-702-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 HARBOR AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131322",
            "telephone_number": "310-702-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SHERRI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 26749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Mark Nicolas
• Kevin Adam Nicolau
• Nicole Abadi, Marriage and Family Therapist, Inc
• Nicole Thorn
• Jerod Nielsen
• Tiffany Kim Nielsen, MSN, FNP-C, RN
• Kaylynn Isabella Nieto
• Fabiola Nieves
• Tyler Robert Nieves
• Micaela Niezen

• Clinical Psychologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.