Affiliated Psychologists & Counselors, Inc.
Organization Active NPI Psychologist · Cupertino, CA
NPI 1598877201 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1598877201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY 4771 (CA)
- Legal business name
- AFFILIATED PSYCHOLOGISTS & COUNSELORS, INC.
- Practice address
- 20833 Stevens Creek Blvd
Suite 100
Cupertino, CA 95014-2154 - Phone
- (408) 342-0612
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Diana Sullivan Everstine, PH.D.
- Title
- President
- Phone
- (408) 342-0612
Practitioners 11
-
Priya Mahurkar, PH.D.
-
Gerry Mary Waniewski, PSY.D.
-
Patricia Jane Baker, MARRIAGE & FAMILY TH
-
Noah Goldin Bruce, PSYD
-
Sarita Maria Ledet, MFT
-
Erika Celia Mozer, PSYD
-
Yu Pan, PH.D.
-
Mark C Purcell, PSY.D.
-
Linda G Sattler, PSY.D.
-
Jessica Sparks, MS, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110131000217 | CA | Part B Supplier - Clinic/Group Practice | 7416136999 |
Receives reassigned benefits from 3 practitioners Practice locations: Cupertino, CA |
National Provider Directory
Locations
20863 Stevens Creek Blvd
Ste 580
Cupertino, CA 95014
Phone (408) 342-0612
20833 Stevens Creek Blvd
Ste 100
Cupertino, CA 95014
Phone (408) 342-0612
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | PSY 4771 | CA | Yes |
Addresses
Primary practice location
20833 Stevens Creek Blvd
Suite 100
Cupertino, CA 95014-2154
Mailing address
20833 Stevens Creek Blvd
Suite 100
Cupertino, CA 95014-2154
Phone (408) 342-0612
Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.