Individual provider Active NPI

Rosario Puga-Dempsey

  • Mental Health Counselor
  • San Jose, CA
National Provider Identifier
1023486230
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2625 Zanker Rd
San Jose, CA 95134-2130
Phone
(140) 832-5243
NPI assigned
Sep 3, 2015
Last updated
Sep 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2625 Zanker Rd
San Jose, CA 95134-2130

Mailing address

2625 Zanker Rd
San Jose, CA 95134-2130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
130539CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life in Harmony Therapy Center for Healing and Hope Mental Health Current Accepting new patients
Octave Behavioral Health PC Past Accepting new patients

Locations

3880 S Bascom Ave
Ste 216
San Jose, CA 95124
Phone (408) 236-2111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1023486230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 ZANKER RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 ZANKER RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342130",
            "telephone_number": "140-832-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGA-DEMPSEY",
        "first_name": "ROSARIO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.