Active NPI
Zakiyyah Johnice Ziyadhyatt, PSYD
- Professional Counselor
- San Jose, CA
National Provider Identifier
1598240178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 117679
- Practice address
- 1650 Zanker Rd Ste 230
San Jose, CA 95112-1129 - Phone
- (408) 590-8655
- NPI assigned
- Sep 28, 2018
- Last updated
- Sep 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CA | ||
| Professional Counselor | 101YP2500X | 117679 | CA | Primary |
Addresses
Primary practice location
1650 Zanker Rd Ste 230
San Jose, CA 95112-1129
Mailing address
1650 Zanker Rd Ste 230
San Jose, CA 95112-1129
Phone (408) 590-8655
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YP2500X | Medicaid | CA | |
| 405300000X | Medicaid | CA | |
| 103T00000X | Medicaid | CA | |
| 103TE1000X | Medicaid | CA | |
| 101YM0800X | Medicaid | CA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117679 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1598240178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 ZANKER RD STE 230",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951121129",
"telephone_number": "408-590-8655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 ZANKER RD STE 230",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951121129",
"telephone_number": "408-590-8655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIYADHYATT",
"first_name": "ZAKIYYAH",
"middle_name": "JOHNICE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-28",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "117679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YP2500X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "405300000X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103T00000X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103TE1000X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YM0800X",
"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 Sep 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.