Active NPI
Jennifer Gregg, PH.D.
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1013180488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21907
- Practice address
- Dept of Psychology
One Washington Square
San Jose, CA 95192-0120 - Phone
- (650) 743-7230
- NPI assigned
- Apr 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY21907 | CA | Primary |
| Health Psychologist | 103TH0004X | PSY21907 | CA |
Addresses
Primary practice location
Dept of Psychology
One Washington Square
San Jose, CA 95192-0120
Mailing address
Dept of Psychology
One Washington Square
San Jose, CA 95192-0120
Phone (650) 743-7230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21907 | CA | MD | Health Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1013180488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT OF PSYCHOLOGY",
"address_2": "ONE WASHINGTON SQUARE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951920120",
"telephone_number": "650-743-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DEPT OF PSYCHOLOGY",
"address_2": "ONE WASHINGTON SQUARE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951920120",
"telephone_number": "650-743-7230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGG",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21907",
"primary": true
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "CA",
"license": "PSY21907",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.