Active NPI
Nuredin Indris, B.A.
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1861961187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 137078
- Practice address
- 1898 The Alameda
San Jose, CA 95126-1733 - Phone
- (408) 928-1700
- Fax
- (408) 928-1701
- NPI assigned
- Nov 15, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | 137078 | CA | Primary |
Addresses
Primary practice location
1898 The Alameda
San Jose, CA 95126-1733
Mailing address
1898 The Alameda
San Jose, CA 95126-1733
Phone (408) 928-1700
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
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 137078 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1861961187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1898 THE ALAMEDA",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261733",
"telephone_number": "408-928-1700",
"fax_number": "408-928-1701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1898 THE ALAMEDA",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261733",
"telephone_number": "408-928-1700",
"fax_number": "408-928-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDRIS",
"first_name": "NUREDIN",
"credential": "B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-15",
"last_updated": "2023-04-05",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "137078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
- Indian Health Center of Santa Clara Valley
- Indian Health Center of Santa Clara Valley
- Indian Health Center of Santa Clara Valley
- Individual Kneads
- Bette Indman, EDD, MFT
- Venkata Siddardha Varma Indukuri
- Nicole Puanani Ines, CPNP-PC
- Infinity Dental Group
- Infinity Family Home Care, LLC
- Infocus Physical Therapy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.