NICOLE SALLY LIGHTMAN PHD
NPI 1164735551
Psychologist - Clinical Child & Adolescent in Newport Beach, CA

Q: What is Nicole Lightman's NPI number?

The NPI number for Nicole Lightman is 1164735551. It was assigned to this individual provider in the NPPES registry on July 14, 2010.

Q: What is Nicole Lightman's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Lightman was last updated on August 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2010PECOS EnrolledAccepts Medicare Assignment

4700 VON KARMAN AVE STE 102, NEWPORT BEACH, CA 92660(949) 743-1457(949) 629-2500 Get Directions Write a Review

NPPES record last updated: August 30, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 30, 2018, May 10, 2018 (2 updates tracked since 2018).

On this page

About Nicole Sally Lightman Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE SALLY LIGHTMAN PHD (NPI 1164735551) is an individual clinical child & adolescent provider in Newport Beach, California, licensed in California (PSY28608) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS, maintains a secondary practice location in Costa Mesa, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1164735551

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameNICOLE SALLY LIGHTMANCredential: PHD

Location Address4700 VON KARMAN AVE STE 102Newport Beach, CA 92660

Mailing AddressPo Box 26224Santa Ana, CA 92799-6224 · (520) 400-8171

Phone(949) 743-1457

Fax(949) 629-2500

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateJuly 14, 2010

Last NPPES UpdateAugust 30, 20182 updates tracked since enumeration

✔ NPI 1164735551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in CA · PSY28608

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

4700 VON KARMAN AVE STE 102, Newport Beach, CA 92660

Open in Google Maps ↗

Secondary Practice Location 1

Location 13400 Avenue Of The Arts Apt A220Costa Mesa, CA 92626-7116 · Phone (520) 400-8171

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Sally Lightman Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880967348

PECOS Enrollment IDI20170905001177

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Lightman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Julia Evans Phd Psychology PC

2.6 mi

Clinical

940 S COAST DR STE 225
Costa Mesa, CA 92626

Reassigned Medicare billing, California enrollment
26 clinicians in this Medicare group

NPI 1861902280 (949) 743-1457

Allied Psychological Services, P.C.

4.2 mi

Clinical

23 CORPORATE PLAZA DR STE 150
Newport Beach, CA 92660

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Allied Psychological Services PC
9 clinicians in this Medicare group

NPI 1619487287 (949) 329-7337

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEYOND BEAUTY MEDICAL SPA INC

General Practice