Vericare of California Medical Group

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

VERICARE OF CALIFORNIA MEDICAL GROUP

Practice address

2707 Pine St
San Francisco, CA 94115-2522

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

May 18, 2006

Reactivated

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Melissa King

Title

Director, Credentialing Enrollment

Phone

(800) 370-3651

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Vericare Doing business as

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1164475299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 PINE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152522",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE OF CALIFORNIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2017-07-11",
        "deactivation_date": "2007-04-11",
        "reactivation_date": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING ENROLLMENT",
        "authorized_official_telephone_number": "800-370-3651"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPS000150",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7816",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emanuel N Vergis, MD
• Jessica Rose Verhein
• Carine France Verheyen, M.A.
• Michael S Verhille, M.D.
• Vericare of California Medical Group
• Verissa Lam Optometry Corporation
• William Verlinden, DDS, MD
• Dhruv Verma, M.D.
• Kajal Verma
• Kristy Verma, LPCC #13286

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.