Organization Active NPI

Mindful Psychotherapy, Inc.

  • Clinical Psychologist
  • San Jose, CA
National Provider Identifier
1073841276
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 23133 Issued in CA
Legal business name
MINDFUL PSYCHOTHERAPY, INC.
Practice address
1685 Westwood Dr Ste 6
San Jose, CA 95125-5104
Phone
(858) 353-3345
Fax
(858) 800-4803
NPI assigned
Nov 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Archana Jajodia, PHDNPI 1982932182
Title
President
Phone
(858) 353-3345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X PSY 23133 CA
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X PSY 23133 CA
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X PSY 23133
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 23133 CA Primary

Addresses

Primary practice location

1685 Westwood Dr Ste 6
San Jose, CA 95125-5104

Mailing address

1541 Camino Monde
San Jose, CA 95125-3704
Phone (858) 353-3345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130606000606 CA Part B Supplier - Clinic/Group Practice 1850539644 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

6540 Lusk Blvd
Ste C138
San Diego, CA 92121
Phone (858) 353-3345

4370 La Jolla Village Dr
Ste 400
San Diego, CA 92122
Phone (858) 229-4363

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1073841276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 CAMINO MONDE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253704",
            "telephone_number": "858-353-3345",
            "fax_number": "858-452-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 WESTWOOD DR STE 6",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255104",
            "telephone_number": "858-353-3345",
            "fax_number": "858-800-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL PSYCHOTHERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-27",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "JAJODIA",
        "authorized_official_first_name": "ARCHANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-353-3345",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY 23133",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY 23133",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": "PSY 23133",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23133",
            "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 Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.