Individual provider Active NPI

Aksheta Suresh Kuttuva, M.A. CLINICAL PSYCH

  • Counseling Psychologist
  • Fremont, CA
National Provider Identifier
1891461794
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
39420 Liberty St Ste 252
Fremont, CA 94538-2297
Phone
(510) 745-9151
Fax
(510) 745-9152
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

39420 Liberty St Ste 252
Fremont, CA 94538-2297

Mailing address

3075 Adeline St Ste 120
Berkeley, CA 94703-2579

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
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Portia Bell Hume Behavioral Health and Training Center CurrentSince Jul 16, 2023 Accepting new patients
Through the Looking Glass CurrentSince Aug 1, 2021 Accepting new patients
Portia Bell Hume Behavioral Health and Training Center CurrentSince Jul 16, 2023 Accepting new patients

Locations

3075 Adeline St
Ste 120
Berkeley, CA 94703
Phone (510) 225-7572

39420 Liberty St
Ste 252
Fremont, CA 94538
Phone (925) 338-7928

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1891461794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 ADELINE ST STE 120",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST STE 252",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382297",
            "telephone_number": "510-745-9151",
            "fax_number": "510-745-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTUVA",
        "first_name": "AKSHETA",
        "middle_name": "SURESH",
        "name_prefix": "Ms.",
        "credential": "M.A. CLINICAL PSYCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.