Individual provider Active NPI

Christopher Scott Polizzi, PSY.D.

  • Clinical Psychologist
  • Campbell, CA
National Provider Identifier
1093967200
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22255 Issued in CA
Practice address
901 Campisi Way
Ste 150
Campbell, CA 95008-2365
Phone
(408) 827-1942
Fax
(408) 628-0042
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22255 CA Primary

Addresses

Primary practice location

901 Campisi Way
Ste 150
Campbell, CA 95008-2365

Mailing address

901 Campisi Way
Ste 150
Campbell, CA 95008-2365
Phone (408) 827-1942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000378 CA Practitioner - Clinical Psychologist 0143386250 Practice locations: Campbell, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 Union Ave
Suite 220
Campbell, CA 95008-3162
Phone (408) 827-1942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY22255CAMDClinical Psychologist
22255CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Silicon Valley Psychology Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1093967200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CAMPISI WAY",
            "address_2": "STE 150",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082365",
            "telephone_number": "408-827-1942",
            "fax_number": "408-628-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPISI WAY",
            "address_2": "STE 150",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082365",
            "telephone_number": "408-827-1942",
            "fax_number": "408-628-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZZI",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.