Individual provider Active NPI

Collins Tse Chiu, PSYD

  • Psychologist
  • Santa Clara, CA
National Provider Identifier
1013087279
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY21063 Issued in CA
Practice address
3964 Rivermark PLZ
Ste #115
Santa Clara, CA 95054-4155
Phone
(408) 930-8383
Fax
(800) 853-5155
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY21063 CA Primary

Addresses

Primary practice location

3964 Rivermark PLZ
Ste #115
Santa Clara, CA 95054-4155

Mailing address

3964 Rivermark PLZ
Ste #115
Santa Clara, CA 95054-4155
Phone (408) 930-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000283 CA Practitioner - Clinical Psychologist 1052583192 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1885 The Alameda
Suite 100 J
San Jose, CA 95126-1744
Phone (408) 930-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY21063CAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1013087279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 RIVERMARK PLZ",
            "address_2": "STE #115",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950544155",
            "telephone_number": "408-930-8383",
            "fax_number": "800-853-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 RIVERMARK PLZ",
            "address_2": "STE #115",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950544155",
            "telephone_number": "408-930-8383",
            "fax_number": "800-853-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "COLLINS",
        "middle_name": "TSE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.