Active NPI
Originpsych: Evaluation and Training Practice, PLLC
- Psychologist
- San Antonio, TX
National Provider Identifier
1063326247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- ORIGINPSYCH: EVALUATION AND TRAINING PRACTICE, PLLC
- Practice address
- 8637 Fredericksburg Rd Ste 400-120
San Antonio, TX 78240-1219 - Phone
- (210) 461-8950
- NPI assigned
- Oct 2, 2026
- Last updated
- Oct 2, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Yimi Isimenmen Omofuma, PHD, MSCP
- Title
- Psychologist/Owner
- Phone
- (210) 461-8950
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
8637 Fredericksburg Rd Ste 400-120
San Antonio, TX 78240-1219
Mailing address
8637 Fredericksburg Rd Ste 400-120
San Antonio, TX 78240-1219
Phone (210) 461-8950
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychologist
- San Antonio, TX
- NPI 1497208045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790899200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790899200000",
"number": "1063326247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8637 FREDERICKSBURG RD STE 400-120",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401219",
"telephone_number": "210-461-8950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8637 FREDERICKSBURG RD STE 400-120",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401219",
"telephone_number": "210-461-8950"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORIGINPSYCH: EVALUATION AND TRAINING PRACTICE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-02",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A",
"authorized_official_last_name": "OMOFUMA",
"authorized_official_first_name": "YIMI",
"authorized_official_middle_name": "ISIMENMEN",
"authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
"authorized_official_telephone_number": "210-461-8950",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD, MSCP"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.