Individual provider Active NPI

Kirin Sidhu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1609768530
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95035691 Issued in CA
Practice address
1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone
(925) 282-1778
NPI assigned
Jul 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95035691 CA Primary
Registered Nurse 163W00000X 95171387 CA

Addresses

Primary practice location

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908

Mailing address

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251209001622 CA Practitioner - Nurse Practitioner 4587158480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

1245 S Winchester Blvd
Suite 110
San Jose, CA 95128-3908
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95171387CAMDRegistered Nurse
95035691CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Nov 25, 2025 Accepting new patients

Locations

1245 S Winchester Blvd
Ste 110
San Jose, CA 95128
Phone (415) 296-5299

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1609768530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "KIRIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95035691",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95171387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.