Active NPI
Therese Marie Russi-Schou I, PH.D.
- Psychologist
- San Jose, CA
National Provider Identifier
1306203955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY15359
- Practice address
- 1302 Lincoln Ave
San Jose, CA 95125-3015 - Phone
- (408) 471-6700
- NPI assigned
- Jan 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | PSY15359 | CA | Primary |
Addresses
Primary practice location
1302 Lincoln Ave
San Jose, CA 95125-3015
Mailing address
PO Box 6563
San Jose, CA 95150-6563
Phone (408) 471-6700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 23, 2023 through Feb 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15359 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1306203955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6563",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951506563",
"telephone_number": "408-471-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 LINCOLN AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951253015",
"telephone_number": "408-471-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSI-SCHOU",
"first_name": "THERESE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-26",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY15359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.