Angela Kondo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95017017 Issued in CA

Practice address

2542 S Bascom Ave Ste 100
Campbell, CA 95008-5541

Phone

(408) 559-3403

NPI assigned

Nov 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

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

• LGTC Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1881482941

  Psychiatric/Mental Health

  NPD (past)
• LGTC Inc

  • Registered Dietitian
  • San Jose, CA
  • NPI 1710749494
  NPD (past)
• Los Gatos Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1518600972
  NPD (past)
• WK Medical Group

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1588083992

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1033755053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 S BASCOM AVE STE 100",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085541",
            "telephone_number": "408-559-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 S BASCOM AVE STE 100",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085541",
            "telephone_number": "408-559-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDO",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017017",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robbert Kokeny
• Polyxene G. Kokinos, MD
• Michael Komar, RT
• Suvarchala Surya Rama Kompella
• Saryna Konczey
• Colleen Gayle Kong, RDH
• Linda Rie Kono, D.M.D.
• Vinay Kowshik
• Michelle Krause, MA
• Tonja Krautter, PSY.D.

• Psychiatric/Mental Health Nurse Practitioner in Campbell, CA
• Providers in Campbell, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.