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NICOLE M. HISAKA M.A.
NPI 1356716039
Psychologist - Clinical in Los Angeles, CA

Active since December 07, 2015PECOS Enrolled
760 WESTWOOD PLZ # A8-159, LOS ANGELES, CA 90024(310) 794-0678 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 27, 2023, Jul 19, 2022, Jul 12, 2018 and 1 more (4 updates tracked since 2015).

About Nicole M. Hisaka M.a. NPPES

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

NICOLE M. HISAKA M.A. (NPI 1356716039) is an individual clinical provider in Los Angeles, California, licensed in California (33188) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1356716039
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameNICOLE M. HISAKACredential: M.A.
Location Address760 WESTWOOD PLZ # A8-159Los Angeles, CA 90024-5055
Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631 · (310) 301-8771
Phone(310) 794-0678
Sole ProprietorNo
Enumeration DateDecember 7, 2015
Last NPPES UpdateOctober 27, 20234 updates tracked since enumeration
NPPES CertifiedJuly 19, 2022
✔ NPI 1356716039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 33188
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
760 WESTWOOD PLZ # A8-159, Los Angeles, CA 90024
Open in Google Maps ↗

Secondary Practice Locations 2

Location 112016 Wilshire Blvd Ste 4Los Angeles, CA 90025-1205 · Phone (310) 442-1500
Location 23651 Business DrSacramento, CA 95820-2175 · Phone (925) 963-3008

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole M. Hisaka M.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

2

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

Uc Regents
0.4 mi
Adult Development & Aging
300 MEDICAL PLAZA
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 221 clinicians in this Medicare group
NPI 1750368999 (310) 825-9989
Southern California Permanente Medical Group
4.5 mi
Health Maintenance Organization
6041 CADILLAC AVE
Los Angeles, CA 90034
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1043242563 (323) 857-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90024 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Hisaka's NPI number?

The NPI number for Nicole Hisaka is 1356716039. It was assigned to this individual provider in the NPPES registry on December 7, 2015.

Where is Nicole Hisaka located?

Nicole Hisaka practices at 760 Westwood Plz # A8-159, Los Angeles, CA 90024. The listed phone number is (310) 794-0678.

What is Nicole Hisaka's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Nicole Hisaka enrolled in Medicare?

Yes. Nicole Hisaka is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicole Hisaka's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Hisaka reassigns Medicare benefits to 2 organizations: Uc Regents (Los Angeles, CA) and Southern California Permanente Medical Group (Los Angeles, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Hisaka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Hisaka was last updated on October 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.