Active NPI
Nicolette Elena Varzos, PH.D.
- Clinical Psychologist
- Sacramento, CA
National Provider Identifier
1881791143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY15617
- Practice address
- 2140 Marshall Way
Sacramento, CA 95818-3544 - Phone
- (916) 849-0843
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY15617 | CA | Primary |
Addresses
Primary practice location
2140 Marshall Way
Sacramento, CA 95818-3544
Mailing address
4750 J St Unit 19516
Sacramento, CA 95819-5021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY15617 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2023 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15617 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708041600000",
"number": "1881791143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 J ST UNIT 19516",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958195021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 MARSHALL WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958183544",
"telephone_number": "916-849-0843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARZOS",
"first_name": "NICOLETTE",
"middle_name": "ELENA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY15617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PSY15617",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
- Michaela Varner
- Martin Michael Varrial, PSY.D.
- Brent J. Varshawsky, D.M.D.
- Beverly B Varughese, PA-C
- Biju Varughese, M.D.
- Hari Rajan Vasanth Kumar, B.SC., B.A.
- Joann Maria Vasconcellos
- Vascular Institute California PC
- Vascular Institute of Northern California, a Podiatry Corporation
- Rosemary Vaske, R.N.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.