Active NPI
Kerry Hubel, PH.D.
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1619399052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY26160
- Practice address
- 123 Di Salvo Ave Ste 40
San Jose, CA 95128-1714 - Phone
- (408) 462-0442
- Fax
- (408) 549-2472
- NPI assigned
- Jan 18, 2014
- 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 |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | PSY26160 | CA | |
| Clinical Psychologist | 103TC0700X | PSY26160 | CA | Primary |
Addresses
Primary practice location
123 Di Salvo Ave Ste 40
San Jose, CA 95128-1714
Mailing address
1010 Fulton Ave
Sunnyvale, CA 94089-1509
Phone (408) 306-4139
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140624001479 | CA | Practitioner - Clinical Psychologist | 7113141441 | Practice locations: San Jose, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
123 Di Salvo Ave
Suite 40
San Jose, CA 95128-1714
Phone (408) 462-0442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26160 | CA | MD | Clinical Psychologist |
| 26160 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1619399052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 FULTON AVE",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940891509",
"telephone_number": "408-306-4139",
"fax_number": "408-549-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 DI SALVO AVE STE 40",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951281714",
"telephone_number": "408-462-0442",
"fax_number": "408-549-2472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBEL",
"first_name": "KERRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-18",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "CA",
"license": "PSY26160",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY26160",
"primary": true
}
],
"identifiers": [],
"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 Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.