Individual provider Active NPI

Radhika Reddy, PH.D.

  • Clinical Psychologist
  • Redwood City, CA
National Provider Identifier
1205283553
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
28023 Issued in CA
Practice address
1400 Veterans Blvd
4TH Floor, Psychiatry Department
Redwood City, CA 94063-2612
Phone
(650) 299-6087
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 28023 CA Primary

Addresses

Primary practice location

1400 Veterans Blvd
4TH Floor, Psychiatry Department
Redwood City, CA 94063-2612

Mailing address

1400 Veterans Blvd
4TH Floor, Psychiatry Department
Redwood City, CA 94063-2612
Phone (650) 299-6087

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20160722002334 CA Practitioner - Clinical Psychologist 9032402482 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28023CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Jul 8, 2021 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1400 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-4338

905 Maple St
Redwood City, CA 94063
Phone (510) 625-4101

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

1400 Veterans Blvd
Fl 4
Redwood City, CA 94063
Phone (650) 299-4309

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 2

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1205283553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VETERANS BLVD",
            "address_2": "4TH FLOOR, PSYCHIATRY DEPARTMENT",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632612",
            "telephone_number": "650-299-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VETERANS BLVD",
            "address_2": "4TH FLOOR, PSYCHIATRY DEPARTMENT",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632612",
            "telephone_number": "650-299-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "RADHIKA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "28023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "905 Maple St.",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.