Active NPI
Jodi Suzanne Couick
- Clinical Psychologist
- Richmond, CA
National Provider Identifier
1730558909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY12597
- Practice address
- 3000 Parker Rd
Richmond, CA 94806-2742 - Phone
- (510) 915-2654
- Fax
- (510) 724-8829
- NPI assigned
- Sep 17, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | CA | ||
| Clinical Psychologist | 103TC0700X | PSY12597 | CA | Primary |
Addresses
Primary practice location
3000 Parker Rd
Richmond, CA 94806-2742
Mailing address
3000 Parker Rd
Richmond, CA 94806-2742
Phone (510) 915-2654
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12597 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1730558909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 PARKER RD",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948062742",
"telephone_number": "510-915-2654",
"fax_number": "510-724-8829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 PARKER RD",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948062742",
"telephone_number": "510-915-2654",
"fax_number": "510-724-8829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUICK",
"first_name": "JODI",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-17",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY12597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.