Individual provider Active NPI

Shruti Patel

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1447659750
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121868 Issued in CA
Practice address
208 Terraine St
San Jose, CA 95110-2558
Phone
(209) 623-8718
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 121868 CA Primary

Addresses

Primary practice location

208 Terraine St
San Jose, CA 95110-2558

Mailing address

208 Terraine St
San Jose, CA 95110-2558
Phone (209) 623-8718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, ID, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250423001718 CO Practitioner - Marriage and Family Therapist 4981129830 Reassigns benefits to 1 organization
I20250425001635 ID Practitioner - Marriage and Family Therapist 4981129830 Reassigns benefits to 1 organization
I20250501002909 CA Practitioner - Marriage and Family Therapist 4981129830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Mar 28, 2025 Accepting new patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Mar 18, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

Organizations & group practices 2

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1447659750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 TERRAINE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951102558",
            "telephone_number": "209-623-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 TERRAINE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951102558",
            "telephone_number": "209-623-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHRUTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.