Fern Selzer, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY8906 Issued in CA

Practice address

4010 Moorpark Ave Ste 118
San Jose, CA 95117-1804

Phone

(831) 475-9091

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Mindful Child & Family Therapy, Inc

  • Marriage & Family Therapist
  • Los Altos, CA
  • NPI 1780156877
  NPD
• Pacific Ketamine and Wellness, a Professional Nursing Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Cruz, CA
  • NPI 1629882956
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1194730598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 MOORPARK AVE STE 118",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171804",
            "telephone_number": "831-475-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MOORPARK AVE STE 118",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171804",
            "telephone_number": "831-475-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELZER",
        "first_name": "FERN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8906",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY8906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Selke, DO
• Ayla Sellers
• Daniel Robert Sellers
• Emily Rose Sellers
• Ambica Selvaraj
• Brandon Seminatore, MD
• Leo B Semkiw, M.D.
• Mamatha Sen
• Juan Sencion
• Doreen Sendig

• Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.