Individual provider Active NPI

Adi Edit Zief-Balteriski, PH.D

  • Clinical Psychologist
  • San Jose, CA
National Provider Identifier
1528216322
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28053 Issued in CA
Practice address
1101 S Winchester Blvd
Suit H-190
San Jose, CA 95128-3901
Phone
(408) 601-0384
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY28053 CA Primary

Addresses

Primary practice location

1101 S Winchester Blvd
Suit H-190
San Jose, CA 95128-3901

Mailing address

1101 S Winchester Blvd
Suit H-190
San Jose, CA 95128-3901
Phone (408) 601-0384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY28053CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1528216322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S WINCHESTER BLVD",
            "address_2": "SUIT H-190",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283901",
            "telephone_number": "408-601-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S WINCHESTER BLVD",
            "address_2": "SUIT H-190",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283901",
            "telephone_number": "408-601-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEF-BALTERISKI",
        "first_name": "ADI",
        "middle_name": "EDIT",
        "name_prefix": "Mrs.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28053",
            "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 Jul 21, 2016; 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.