Individual provider Active NPI

Rob M Grellman, LMFT, PSYD

  • Professional Counselor
  • San Jose, CA
National Provider Identifier
1023675626
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LMFT36930 Issued in CA
Practice address
3880 S Bascom Ave Ste 212
San Jose, CA 95124-2675
Phone
(408) 486-6711
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X LMFT36930 CA Primary

Addresses

Primary practice location

3880 S Bascom Ave Ste 212
San Jose, CA 95124-2675

Mailing address

3880 S Bascom Ave Ste 212
San Jose, CA 95124-2675
Phone (408) 486-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT36930CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1023675626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 212",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-486-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 212",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-486-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRELLMAN",
        "first_name": "ROB",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LMFT, PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LMFT36930",
            "primary": true
        }
    ],
    "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 Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.