Racheal Korede

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95037990 Issued in CA

Practice address

5201 Great America Pkwy
Santa Clara, CA 95054-1122

Phone

(646) 201-8959

Fax

(631) 615-6081

NPI assigned

Nov 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ever Radiant Behavioral Health PLLC

  • Psychiatric/Mental Health Registered Nurse
  • Richmond, TX
  • NPI 1699603118
  NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  WA

  Medicare reassignment

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1295037380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE ROAD",
            "address_2": "BUILDING 1",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "11704",
            "telephone_number": "631-321-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541122",
            "telephone_number": "646-201-8959",
            "fax_number": "631-615-6081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Farmingdale Road",
            "address_2": "building 1",
            "address_purpose": "LOCATION",
            "city": "West babylon",
            "state": "NY",
            "postal_code": "11704",
            "country_code": "US",
            "telephone_number": "631-321-8229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOREDE",
        "first_name": "RACHEAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10035974",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95037990",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "768437-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407033",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "106080",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70022172",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swarna L Koneru, RD
• Jenna Konno, LCSW
• Hilary Jeng-Men Koo, LCSW
• Stacy Kopp
• Joel S. Koransky, M.D.
• Louisa Miriam Kornblatt, LCSW
• Barbara Licht Korthamar, MD
• Eric M. Koscove, MD
• Merrit Alexis Hoover Koskelo, MD, PHD
• Mark Bruno Kovacic, RN

• Psychiatric/Mental Health Nurse Practitioner in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.