Individual provider Active NPI

Karen Radella, PH.D.

  • Psychologist
  • San Jose, CA
National Provider Identifier
1649372137
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY15059 Issued in CA
Practice address
1302 Lincoln Ave Ste 205
San Jose, CA 95125-3015
Phone
(408) 866-8570
Fax
(408) 278-9030
NPI assigned
Sep 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY15059 CA Primary

Addresses

Primary practice location

1302 Lincoln Ave Ste 205
San Jose, CA 95125-3015

Mailing address

1302 Lincoln Ave Ste 205
San Jose, CA 95125-3015
Phone (408) 866-8570

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15059CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649372137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 LINCOLN AVE STE 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253015",
            "telephone_number": "408-866-8570",
            "fax_number": "408-278-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 LINCOLN AVE STE 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253015",
            "telephone_number": "408-866-8570",
            "fax_number": "408-278-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADELLA",
        "first_name": "KAREN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15059",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.