Individual provider Active NPI

Nicole Reinosa, PSY.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1861844102
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33894 Issued in CA
Practice address
1001 Potrero Ave # 6B
San Francisco, CA 94110-3518
Phone
(415) 206-5270
Fax
(415) 206-4722
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Information Technician 247000000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY33894 CA Primary

Addresses

Primary practice location

1001 Potrero Ave # 6B
San Francisco, CA 94110-3518

Mailing address

351 Hanover Ave Apt 202
Oakland, CA 94606-5605
Phone (925) 391-0552

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
PSY33894CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California, San Francisco PastSince May 14, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1861844102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HANOVER AVE APT 202",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946065605",
            "telephone_number": "925-391-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE # 6B",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-5270",
            "fax_number": "415-206-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINOSA",
        "first_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.