Individual provider Active NPI

Jillandra Rovaris, PHD

  • Counseling Psychologist
  • Santa Clara, CA
National Provider Identifier
1770104184
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY25526 Issued in CA
Practice address
500 El Camino Real
Santa Clara, CA 95050-4345
Phone
(408) 554-4501
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY25526 CA Primary

Addresses

Primary practice location

500 El Camino Real
Santa Clara, CA 95050-4345

Mailing address

500 El Camino Real
Santa Clara, CA 95050-4345
Phone (408) 554-4501

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrovaris@scu.edu

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

LicenseStateTypeSpecialty
PSY25526CAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1770104184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EL CAMINO REAL",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504345",
            "telephone_number": "408-554-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EL CAMINO REAL",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504345",
            "telephone_number": "408-554-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVARIS",
        "first_name": "JILLANDRA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY25526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrovaris@scu.edu",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "address_1": "500 El Camino Real",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950504345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.

Verify at the official NPI Registry.