Active NPI
Sanji Marissa Coutts, PHD
- Psychologist
- Santa Cruz, CA
National Provider Identifier
1245340652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 17944
- Practice address
- 1663 Dominican Way
Suite 214
Santa Cruz, CA 95065 - Phone
- (831) 462-1761
- Fax
- (831) 462-4936
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 17944 | CA | Primary |
Addresses
Primary practice location
1663 Dominican Way
Suite 214
Santa Cruz, CA 95065
Mailing address
1663 Dominican Way
Suite 214
Santa Cruz, CA 95065
Phone (831) 462-1761
Other names 1
- Sanji Rosenberg
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110202000244 | CA | Practitioner - Clinical Psychologist | 7214117639 | Practice locations: Santa Cruz, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1663 Dominican Way
Santa Cruz, CA 95065-1556
Phone (831) 762-1761
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17944 | CA | MD | Psychologist |
| 17944 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245340652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1663 DOMINICAN WAY",
"address_2": "SUITE 214",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "95065",
"telephone_number": "831-462-1761",
"fax_number": "831-462-4936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1663 DOMINICAN WAY",
"address_2": "SUITE 214",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "95065",
"telephone_number": "831-462-1761",
"fax_number": "831-462-4936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUTTS",
"first_name": "SANJI",
"middle_name": "MARISSA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 17944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANJI",
"last_name": "ROSENBERG",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.