NICOLE R MOTAKEF (NPI# 1609308758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609308758 |
| Entity Type | Individual |
| Full Name | NICOLE R MOTAKEF |
| Other Name | NICOLE C ROUSE |
| Credential | D.O. |
| Practice Address |
101 The City Dr S Bldg 3 Orange CA 92868-3201 |
| Mailing Address |
17234 Valley Blvd Fontana CA 92335-6851 |
| Practice Telephone | 9498241283 |
| Mailing Telephone | 9512011453 |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2020-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
20A16793 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17234 Valley Boulevard, Fontana, CA 923356851 | 9512011453 |
| Street Address |
101 THE CITY DR S BLDG 3 |
| City | ORANGE |
| State | CA |
| Zip Code | 92868-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841317609 | Kerry Ellen Wangen | Psychiatry & Neurology | 101 The City Dr S Bldg 3, Department of Psychiatry, Orange, CA 92868-3201 | 2007-03-24 |
| 1609497916 | Gabrielle Stetz | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-04-28 |
| 1366062341 | Corina Nicole Vasquez | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-04-20 |
| 1801415070 | Jamie A Fortman | Psychiatry & Neurology | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-04-08 |
| 1376171603 | Jericha Viduya | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-03-31 |
| 1487282455 | Nikki Nguyen | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-03-27 |
| 1356978621 | Joseph Son | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-03-25 |
| 1932736303 | Andrew Tung | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2020-03-25 |
| 1467929067 | Ivy Y Chen | Psychologist | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2018-11-01 |
| 1407334428 | Lydia Kim | Student in an Organized Health Care Education/Training Program | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2018-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346859386 | Sadaf Abrishami | Pharmacist | 101 The City Dr S., Orange, CA 92868 | 2020-07-27 |
| 1245869825 | Helena Yijia Hong | Student in an Organized Health Care Education/Training Program | Uci Medical Center, 101 The City Drive, Orange, CA 92868 | 2020-04-06 |
| 1932736527 | Joshua Kristopher Livingston | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Rte. 128-01, Orange, CA 92868 | 2020-03-24 |
| 1831725894 | Michelle Brown | Student in an Organized Health Care Education/Training Program | 101 The City Dr S. Rte 128-01, Orange, CA 92868 | 2020-03-20 |
| 1093363491 | Kristin Lee | Pharmacist | 132 S. Anita Dr., Orange, CA 92868 | 2019-08-28 |
| 1740834217 | Matthew Brian Mecheal | Dentist | 725 W. La Veta Suite 260, Orange, CA 92868 | 2019-08-01 |
| 1245897990 | Brent Tyler Louie | Student in an Organized Health Care Education/Training Program | 101 The City Drive South Building 3, Route 88, Neuropsychiatric Center Uc Irvine Medical Center, Orange, CA 92868 | 2019-05-28 |
| 1093277972 | Danielle Amato | Student in an Organized Health Care Education/Training Program | Uc Irvine Health 101 The City Drive, City Tower, Ste 40, Orange, CA 92868 | 2019-04-01 |
| 1851852206 | Julia Ting Bu | Student in an Organized Health Care Education/Training Program | Uc Irvine Health, 101 The City Drive, City Tower, Ste 400, Orange, CA 92868 | 2019-03-28 |
| 1326507344 | Harrison Beene Lowder | Student in an Organized Health Care Education/Training Program | 505 S. Main St, Suite 525, Orange, CA 92868 | 2019-03-19 |
| Find all providers in zip 92868 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578582821 | Thomas Reed | Psychiatry & Neurology | 331 City Dr. South, Orange, CA 92863 | 2006-07-18 |
| 1659918852 | Children's Hospital of Orange County | Psychiatry & Neurology | 170 S Main St, Orange, CA 92868-2801 | 2019-12-06 |
| 1053773028 | Kevin Joshua Hyochan Chun | Psychiatry & Neurology | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2016-03-28 |
| 1699137661 | Manar Ahmed Abdelmegeed | Psychiatry & Neurology | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2016-03-28 |
| 1518300078 | Laura Jacqueline Lai | Psychiatry & Neurology | 1201 W La Veta Ave, Orange, CA 92868 | 2013-04-15 |
| 1003133521 | David Safani | Psychiatry & Neurology | 101 The City Dr S Bldg 3, Orange, CA 92868-3201 | 2010-04-23 |
| 1336382316 | Michael Soonwon Hwang | Psychiatry & Neurology | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2009-04-07 |
| 1043455850 | Advantage Neuropsychiatric Assoc | Psychiatry & Neurology | 1010 W Chapman Ave, Orange, CA 92868-2847 | 2008-12-08 |
| 1770667503 | Pete Joseph Farrell | Psychiatry & Neurology | 301 The City Dr S, Orange, CA 92868-3205 | 2006-10-25 |
| 1871673921 | Gail Fernandez | Psychiatry & Neurology | Uci Medical Center, 101 The City Drive South, Orange, CA 92868 | 2006-10-16 |
| Find all providers in ORANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.