VERICARE OF CALIFORNIA MEDICAL GROUP (NPI# 1194779439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194779439 |
| Entity Type | Organization |
| Organization Name | VERICARE OF CALIFORNIA MEDICAL GROUP |
| Other Organization Name | VERICARE |
| Practice Address |
2501 Alvin Ave San Jose CA 95121-1660 |
| Mailing Address |
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8003703651 |
| Mailing Fax Number | 8775157147 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-07-11 |
| NPI Deactivation Date | 04/11/2007 |
| NPI Reactivation Date | 2007-10-16 |
| Authorized Official Name | MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT) |
| Authorized Official Telephone | 8003703651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CA | Behavioral Health & Social Service Providers | |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
CA | Allopathic & Osteopathic Physicians | |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
CA | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CC7816 | 01 |
| CA | GPS000150 | 05 |
| Other Name | Type Code |
|---|---|
| Vericare | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114053 | Vericare of California Medical Group | Social Worker | 325 Kempton St, Spring Valley, CA 91977-5810 | 2006-05-23 |
| 1316992829 | Vericare of California Medical Group | Social Worker | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2006-05-23 |
| 1275588790 | Vericare of California Medical Group | Social Worker | 1835 W La Veta Ave, Orange, CA 92868-4132 | 2006-05-23 |
| 1164475299 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-18 |
| 1528011764 | Vericare of California Medical Group | Social Worker | 81 Professional Ctr Pkwy, San Rafael, CA 94903-2797 | 2006-05-18 |
| 1407047673 | Vericare of California Medical Group | Nurse Practitioner | 3293 N Drinkwater Blvd, Scottsdale, AZ 85251-6405 | 2007-08-05 |
| 1689629198 | Vericare of California Medical Group | Social Worker | 205 Granada St, Camarillo, CA 93010-7715 | 2006-05-23 |
| 1760437271 | Vericare of California Medical Group | Social Worker | 1505 Colby Dr, Glendale, CA 91205-3307 | 2006-05-23 |
| 1104879980 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-19 |
| 1942254644 | Vericare of California Medical Group | Social Worker | 430 Willow St, Alameda, CA 94501-6130 | 2006-05-19 |
| Street Address |
2501 ALVIN AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95121-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720032329 | Casavina Foundation Corp | Skilled Nursing Facility | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2006-05-19 |
| 1154591436 | Rajeswari Vattyam | Speech-Language Pathologist | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2008-03-03 |
| 1962685248 | Kimberly Ann Sato | Physical Therapy Assistant | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2007-12-10 |
| 1700069333 | Surekha Purushottam Pol | Physical Therapist | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2007-12-05 |
| 1548443179 | Lizabeth Caancan | Occupational Therapist | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922669597 | Tracy Filler, Dmd, Inc. | Dentist | 1569 Lexann Drive, Suite 202, San Jose, CA 95121 | 2019-06-25 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1538681325 | Sujata S Gawande | Dentist | 2060 Aborn Rd Ste 125, San Jose, CA 95121 | 2017-07-12 |
| 1871950188 | Keiana Harrington | Behavioral Analyst | 6958 Del Rio Dr., San Jose, CA 95121 | 2016-01-19 |
| 1679812556 | Hien Van Nguyen | Pediatrics | 1675 Burdette Dr, Ste #20, San Jose, CA 95121 | 2013-02-12 |
| 1013290766 | Minh V Nguy | Dentist | 3161 Senter Road, San Jose, CA 95121 | 2011-09-20 |
| 1528388139 | Vu V. Le Chiro | Chiropractor | 1059 E. Capitol Expressway, San Jose, CA 95121 | 2010-06-04 |
| 1205087012 | Lanni Huynh | Acupuncturist | 2936 Aborn Square, San Jose, CA 95121 | 2008-10-10 |
| 1598936676 | Soumya Shivanna | Dentist | 1620 E.capitol Expressway, Suite C, San Jose, CA 95121 | 2008-03-18 |
| 1144434903 | Jeremy D. Lai | Pharmacist | 1569 Lexann Avenue, Suite 104, San Jose, CA 95121 | 2007-05-10 |
| Find all providers in zip 95121 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760685218 | Sharon Iwen Wang | Psychologist | 2033 Gateway Pl Fl 5, San Jose, CA 95110 | 2007-06-11 |
| 1972719524 | Shannon Susanne Warming | Psychologist | 101 Jose Figueres, San Jose, CA 95116 | 2007-05-14 |
| 1811454382 | Estrella A Ramirez | Psychologist | 1101 S Winchester Blvd Ste P297, San Jose, CA 95128-3904 | 2019-02-21 |
| 1073088258 | Brandon Keith Hoshiko | Psychologist | 1361 S Winchester Blvd Ste 208, San Jose, CA 95128-4328 | 2018-10-03 |
| 1942793443 | Siri Vivek | Psychologist | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2018-06-08 |
| 1285904235 | Carmenluz Diaz | Psychologist | 2625 Zanker Rd, Suite 200, San Jose, CA 95134-2130 | 2012-01-09 |
| 1881977502 | Doylene Chan | Psychologist | 105 N Bascom Ave, Suite 202, San Jose, CA 95128-1811 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376368 | Jamie L Krause | Psychologist | 2134 N Lincoln St Apt 1/2, Burbank, CA 91504-3349 | 2020-11-07 |
| 1861090441 | Illuminating Psychological Services Corporation | Psychologist | 4181 Flat Rock Dr Ste 311, Riverside, CA 92505-7106 | 2020-10-15 |
| 1194322495 | Yong Sue Park | Psychologist | 1913 Wilshire Blvd, Los Angeles, CA 90057-3604 | 2020-10-08 |
| 1811594815 | Dena Schwimmer | Psychologist | 1227 S Genesee Ave, Los Angeles, CA 90019-2407 | 2020-10-03 |
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1932711413 | Tonja M Jackson | Psychologist | 23213 Lynn St, Hayward, CA 94541-7426 | 2020-08-17 |
| 1720606593 | Brejaynae S Joiner | Psychologist | 2310 Mcginley Ave, Antioch, CA 94509-3819 | 2020-07-08 |
| 1407474596 | Devjani Banerjee-stevens | Psychologist | 15 Williamsburg Ln Ste A, Chico, CA 95926-5520 | 2020-07-06 |
| 1255952842 | Sarah E. Wilson, Phd, A Professional Psychology Corporation | Psychologist | 23 Altarinda Road, Suite 201, Orinda, CA 94563 | 2020-05-05 |
| 1427684661 | Lucy Cotter | Psychologist | 205 N Larchmont Blvd, Los Angeles, CA 90004-3706 | 2020-03-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on VERICARE OF CALIFORNIA MEDICAL GROUP.
| 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.