Organization Active NPI

San Jose Integrative Wellness Center Inc

  • Psychiatry Physician
  • Los Gatos, CA
National Provider Identifier
1902280712
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A91711 Issued in CA
Legal business name
SAN JOSE INTEGRATIVE WELLNESS CENTER INC
Practice address
825 Pollard Rd Ste 108
Los Gatos, CA 95032-1435
Phone
(408) 357-0105
Fax
(408) 357-0105
NPI assigned
Jul 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Manuj Kumar Nangia, MDNPI 1437283405
Title
Owner
Phone
(408) 357-0105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A91711 CA Primary

Addresses

Primary practice location

825 Pollard Rd Ste 108
Los Gatos, CA 95032-1435

Mailing address

825 Pollard Rd Ste 108
Los Gatos, CA 95032-1435
Phone (408) 357-0105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251105003938 CA Part B Supplier - Clinic/Group Practice 9436577921 Receives reassigned benefits from 1 practitioner
Practice locations: Los Gatos, CA

National Provider Directory

National Provider Directory

Locations

825 Pollard Rd
Ste 108
Los Gatos, CA 95032
Phone (408) 357-0105

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1902280712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD STE 108",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-357-0105",
            "fax_number": "408-357-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD STE 108",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-357-0105",
            "fax_number": "408-357-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE INTEGRATIVE WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "NANGIA",
        "authorized_official_first_name": "MANUJ",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-357-0105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A91711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.