Individual provider Active NPI

Nick Xiong, PSYD

  • Clinical Psychologist
  • Auburn, CA
National Provider Identifier
1952704553
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35767 Issued in CA
Practice address
13300 New Airport Rd Ste 100
Auburn, CA 95602-7407
Phone
(530) 861-6183
NPI assigned
Sep 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Student in an Organized Health Care Education/Training Program 390200000X CA
Clinical Psychologist 103TC0700X 35767 CA Primary

Addresses

Primary practice location

13300 New Airport Rd Ste 100
Auburn, CA 95602-7407

Mailing address

13300 New Airport Rd Ste 100
Auburn, CA 95602-7407
Phone (530) 861-6183

Other practice location 1

425 University Ave Ste 100
Sacramento, CA 95825-6508
Phone (916) 284-1416

Other practice location 2

500 Fairway Dr
Ste. 102
Deerfield Beach, FL 33441-1814
Phone (888) 880-9270

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250327003082 CA Practitioner - Clinical Psychologist 5496278749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beautiful Minds Medical, Inc.Group PAC ID 3072783364, 14 clinicians

Practice addresses (Care Compare)

13300 New Airport Rd
Suite 100
Auburn, CA 95602-7407
Phone (530) 889-8780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35767CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Point Center for Psychotherapy CurrentSince Oct 1, 2022 Accepting new patients
Beautiful Minds Medical, Inc. CurrentSince Mar 20, 2025 Accepting new patients
Dr. Trisha D Wallis, Psychologist, Apc Clinical CurrentSince Oct 1, 2022 Accepting new patients

Locations

381A Nevada St
Auburn, CA 95603
Phone (530) 368-0571

13300 New Airport Rd
Ste 100
Auburn, CA 95602
Phone (530) 823-5300

425 University Ave
Ste 100
Sacramento, CA 95825
Phone (916) 284-1416

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCJEBA

Organizations & group practices 3

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": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1952704553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 NEW AIRPORT RD STE 100",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956027407",
            "telephone_number": "530-861-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 NEW AIRPORT RD STE 100",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956027407",
            "telephone_number": "530-861-6183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 University Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958256508",
            "country_code": "US",
            "telephone_number": "916-284-1416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Fairway Dr",
            "address_2": "Ste. 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411814",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "XIONG",
        "first_name": "NICK",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-27",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.