NPIMap

Organization Active NPI

Affiliated Psychologists & Counselors, Inc.

  • Psychologist
  • Cupertino, CA
National Provider Identifier
1598877201
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 4771 Issued in 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
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diana Sullivan Everstine, PH.D.NPI 1982737870
Title
President
Phone
(408) 342-0612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY 4771 CA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110131000217 CA Part B Supplier - Clinic/Group Practice 7416136999 Receives reassigned benefits from 3 practitioners
Practice locations: Cupertino, CA

National Provider Directory

National Provider Directory

Locations

20833 Stevens Creek Blvd
Ste 100
Cupertino, CA 95014
Phone (408) 342-0160

20863 Stevens Creek Blvd
Ste 580
Cupertino, CA 95014
Phone (408) 342-0612

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598877201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20833 STEVENS CREEK BLVD",
            "address_2": "SUITE 100",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142154",
            "telephone_number": "408-342-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20833 STEVENS CREEK BLVD",
            "address_2": "SUITE 100",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142154",
            "telephone_number": "408-342-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED PSYCHOLOGISTS & COUNSELORS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVERSTINE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "SULLIVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-342-0612",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 4771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.