NPIMap

Organization Active NPI

Momentum Fro Mental Health - Donnas Place

  • Psychologist
  • San Jose, CA
National Provider Identifier
1477765105
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MOMENTUM FRO MENTAL HEALTH - DONNAS PLACE
Practice address
2001 The Alameda
San Jose, CA 95126-1136
Phone
(408) 261-7777
Fax
(408) 554-9960
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
John S. Smelser
Title
Chief Financial Officer
Phone
(408) 261-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2001 The Alameda
San Jose, CA 95126-1136

Mailing address

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 261-7777

Other identifiers 1

IdentifierTypeStateIssuer
000008389MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Momentum for Mental Health - Assist Solano Outpatient39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1477765105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-554-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-554-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM FRO MENTAL HEALTH - DONNAS PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "SMELSER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "408-261-7777"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000008389",
            "state": "CA"
        }
    ],
    "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 Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.