Individual provider Active NPI

Mansi Verma, PHD

  • Psychologist
  • San Jose, CA
National Provider Identifier
1366050346
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSB94025417 Issued in CA
Practice address
2400 Moorpark Ave
Suite 300
San Jose, CA 95128
Phone
(408) 975-2730
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSB94025417 CA Primary

Addresses

Primary practice location

2400 Moorpark Ave
Suite 300
San Jose, CA 95128

Mailing address

1063 Morse Ave Apt 21-201
Sunnyvale, CA 94089

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
I20241219000272 CA Practitioner - Clinical Psychologist 7012444714 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSB94025417CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Sep 16, 2024 Accepting new patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Sep 16, 2024 Accepting new patients

Locations

2400 Moorpark Ave
Ste 319
San Jose, CA 95128
Phone 4089752730428

2400 Moorpark Ave
Ste 300
San Jose, CA 95128
Phone (408) 975-2763

Organizations & group practices 3

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1366050346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 MORSE AVE APT 21-201",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "94089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "address_2": "SUITE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-975-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMA",
        "first_name": "MANSI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-11-14",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94025417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.