NPIMap

Individual provider Active NPI

Kevin Higgins

  • Clinical Psychologist
  • San Jose, CA
National Provider Identifier
1174818249
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY29234 Issued in CA
Practice address
5504 Monterey Hwy
San Jose, CA 95138-1529
Phone
(408) 729-9700
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Psychologist 103TC0700X PSY29234 CA Primary

Addresses

Primary practice location

5504 Monterey Hwy
San Jose, CA 95138-1529

Mailing address

5504 Monterey Hwy
San Jose, CA 95138-1529
Phone (408) 729-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327001192 CA Practitioner - Clinical Psychologist 0547783839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Community Health 106 clinicians

Practice addresses (Care Compare)

9460 N Name Uno
Suite 110
Gilroy, CA 95020-3536
Phone (408) 729-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY29234CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Health CurrentSince Jan 17, 2025 Accepting new patients
Bay Area Community Health CurrentSince Jan 17, 2025 Accepting new patients
Marin Treatment Center PastSince Aug 2, 2017 Accepting new patients

Locations

1999 Mowry Ave
Fremont, CA 94538
Phone (510) 791-0957

40910 Fremont Blvd
Fremont, CA 94538
Phone (510) 770-8133

1650 S White Rd
San Jose, CA 95127
Phone (408) 928-5250

Organizations & group practices 12

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1174818249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5504 MONTEREY HWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381529",
            "telephone_number": "408-729-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5504 MONTEREY HWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381529",
            "telephone_number": "408-729-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINS",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.