Active NPI
Robert Enoch, PH.D.
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1740632223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 28435
- Practice address
- 5755 Cottle Rd BLDG 24
San Jose, CA 95123-3640 - Phone
- (408) 972-3530
- NPI assigned
- Jul 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 28435 | CA | Primary |
Addresses
Primary practice location
5755 Cottle Rd BLDG 24
San Jose, CA 95123-3640
Mailing address
1374 Buckingham Way
Hayward, CA 94544-6306
Other practice location 1
5000 W National Ave
Milwaukee, WI 53295-0001
Phone (414) 384-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28435 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1740632223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1374 BUCKINGHAM WAY",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945446306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 COTTLE RD BLDG 24",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233640",
"telephone_number": "408-972-3530"
}
],
"practiceLocations": [
{
"address_1": "5000 W National Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532950001",
"country_code": "US",
"telephone_number": "414-384-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENOCH",
"first_name": "ROBERT",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-07",
"last_updated": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "28435",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5755 Cottle Rd",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "95123",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.