Vericare of California Medical Group

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

VERICARE OF CALIFORNIA MEDICAL GROUP

Practice address

2501 Alvin Ave
San Jose, CA 95121-1660

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

May 20, 2006

Reactivated

Oct 16, 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 Other name

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1194779439",
    "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": "2501 ALVIN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211660",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE OF CALIFORNIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-07-11",
        "deactivation_date": "2007-04-11",
        "reactivation_date": "2007-10-16",
        "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": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7816",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPS000150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Uriel Verduzco Aleman Jr.
• Alejandra Inez Vergara, LCSW
• Edegar Vergara, DMD
• Eduardo Vergara Sr., MD
• Nilda Vergara, M.D.
• Verity Billing Solutions LLC
• Verity Medical Foundation
• Verity Medical Foundation
• Irene Apolonia Verkaaik, PA-C
• Serena Verley Rodriguez

• Counseling Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Counseling 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.