WK Medical Group
Organization Active NPI Psychiatry Physician · San Jose, CA
NPI 1588083992 · NPPES record last updated Apr 29, 2025
Key facts
- NPI
- 1588083992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- WK MEDICAL GROUP
- Practice address
- 4850 Union Ave
San Jose, CA 95124-5156 - Phone
- (800) 913-2615
- NPI assigned
- Apr 14, 2014
- Organization subpart
- No
Authorized official
- Name
- Yevgeniy Tilman
- Title
- Executive Director
- Phone
- (408) 505-1873
Corporate family (same tax ID) 4
Practitioners 135
-
Ferhad Ahmad, MD
-
Shellyatta Johnson Beard, LCSW 99953
-
Nataly Sumarriva Beck, M.D.
-
Tirath Singh Gill, M.D.
-
Cori Hanagami, M.D.
-
Kristina Baker Hart, LCSW
-
Fides G Isidro, LCSW
-
Jeremy Joseph Kernion, LCSW
-
D. Katherine McKee, LMFT
-
Stephanne Pleshette, LCSW
-
Elinor Slayer, LMFT
-
Anoushka Tahaei, MFTI
-
Karen Wachtel, MFT-I, CATC
-
Bruce Melvin Wermuth, M.D
-
Rajan Gosain, M.D.
-
Lucia Thomas Olson, LMFT
-
Nupur C Jain, M.A.
-
Jeweleeh Hanh Yu, PA-C
-
Moeen Ahmad Bhatti, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160601000362 | CA | Part B Supplier - Clinic/Group Practice | 6103116348 |
Receives reassigned benefits from 24 practitioners Practice locations: Roseville, CA; Sunnyvale, CA; San Jose, CA; Campbell, CA; Burlingame, CA |
National Provider Directory
- Tax ID family
- LGTC Group
Locations
1575 Old Bayshore Hwy
Ste 201
Burlingame, CA 94010
Phone (408) 542-0399
508 Gibson Dr
Ste 114
Roseville, CA 95678
Phone (916) 694-0555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | |||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Child & Adolescent Psychiatry Physician |
2084P0804X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
4850 Union Ave
San Jose, CA 95124-5156
Mailing address
4850 Union Ave
San Jose, CA 95124-5156
Phone (408) 559-3403
Other practice location 1
2235 Douglas Blvd Ste 500
Roseville, CA 95661-4266
Phone (800) 913-2615
Other practice location 2
1575 Old Bayshore Hwy Ste 201
Burlingame, CA 94010-1616
Phone (800) 913-2615
Other practice location 3
2542 S Bascom Ave Ste 100
Campbell, CA 95008-5541
Phone (800) 913-2615
Other providers in San Jose, CA
- Lynn Withers
- Withyou Care LLC
- David R. Witt
- Gerald George Witters
- Deborah Anne Wittwer Kopp
- WL Health Center
- Genet Reda Wodajo
- Lisa Woffington
- Katrien T Wohlstattar
- Jennifer Nichole Wohlwend
All providers in San Jose, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.