Ambica Selvaraj

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

101 Jose Figueres Avenue
Ste 50
San Jose, CA 95116-2022

Phone

(408) 207-0560

Fax

(408) 642-6052

NPI assigned

Jul 26, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Momentum for Health

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1477906410
  NPD

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1033763172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 THE ALAMEDA STE 316",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261461",
            "telephone_number": "408-261-7777",
            "fax_number": "408-642-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JOSE FIGUERES AVENUE",
            "address_2": "STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162022",
            "telephone_number": "408-207-0560",
            "fax_number": "408-642-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVARAJ",
        "first_name": "AMBICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Val Selivanov, MD
• Henry Selke, DO
• Ayla Sellers
• Daniel Robert Sellers
• Emily Rose Sellers
• Fern Selzer, PH.D.
• Brandon Seminatore, MD
• Leo B Semkiw, M.D.
• Mamatha Sen
• Juan Sencion

• Student in an Organized Health Care Education/Training Program in San Jose, CA
• Providers in San Jose, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.