KRISTIE A NELSON (PH.D.) – Psychologist, NPI 1457656258

KRISTIE A NELSON (PH.D.) is a healthcare provider. based in Modesto, California. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY29568 (CA). The NPI Number for KRISTIE A NELSON (PH.D.) is 1457656258

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KRISTIE A NELSON (PH.D.)
NPI
1457656258
Phone
(209) 604-9682
Address
500 N 9TH ST
Enumeration Date
26 January 2011
Last Update Date
2 November 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2016 (10 years ago)
PAC ID
5890052625
Group Practice PAC ID
0648183996
Professional Enrollment ID
I20171208000293
Address ID
CA953505814MO500XXSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

4,434 CLINICAL PSYCHOLOGIST in CA

Provider Addresses for KRISTIE A NELSON (PH.D.)

  • 500 N 9TH ST

    SUITE A

    MODESTO, CA 953505814

    Phone: (209) 604-9682

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-12-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171208000293IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95350)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648183996View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
-CA
-CA
Occupational Therapist In Private PracticeCA
P S Y C H I A T R YCA
-CA
P S Y C H I A T R YCA
-CA
-CA
Marriage And Family TherapistCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KRISTIE A NELSON (PH.D.)?
KRISTIE A NELSON (PH.D.) — NPI 1457656258 — is the standard way to identify this listing.
Is KRISTIE A NELSON (PH.D.) listed as active for patients and plans?
The listing shows KRISTIE A NELSON (PH.D.) as active in the NPI system.
What is KRISTIE A NELSON (PH.D.)'s specialty?
The listing groups KRISTIE A NELSON (PH.D.) with Psychologist. Clinical services aligned with this taxonomy classification.
Does KRISTIE A NELSON (PH.D.) list a practice location?
Patients near Modesto, California may find KRISTIE A NELSON (PH.D.) in results; validate coverage separately.
Is the information about KRISTIE A NELSON (PH.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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