Individual provider Active NPI

Rodika Vahdat, PSY.D

  • Psychologist
  • San Jose, CA
National Provider Identifier
1366976193
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
94026832 Issued in CA
Practice address
2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680
Phone
(408) 975-2730
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 94026832 CA Primary

Addresses

Primary practice location

2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680

Mailing address

2400 Moorpark Ave
San Jose, CA 95128-2631
Phone (408) 975-2570

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
I20250220003064 CA Practitioner - Clinical Psychologist 6901326917 Reassigns benefits to 2 organizations
Practice locations: Calabasas, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2400 Moorpark Ave
Suite 300
San Jose, CA 95128-2680
Phone (408) 975-2763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
94026832CAMDPsychologist
35696CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Americans for Community Involvement of Santa Clara County, Inc Community/Behavioral Health Current Accepting new patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Feb 10, 2025 Accepting new patients
Asian Americans for Community Involvement of Santa Clara County, Inc Community/Behavioral Health CurrentSince Feb 10, 2025 Accepting new patients

Locations

749 Story Rd
Ste 50
San Jose, CA 95122

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

Organizations & group practices 4

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1366976193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "408-975-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282680",
            "telephone_number": "408-975-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHDAT",
        "first_name": "RODIKA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "94026832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.