Kaiser Santa Theresa Psychiatry Dept

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

LCS21247 Issued in CA

Legal business name

KAISER SANTA THERESA PSYCHIATRY DEPT

Practice address

5755 Cottle Rd
Building 4
San Jose, CA 95014

Phone

(408) 972-3419

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Shannon B Michelson, LCSWNPI 1114051679

Title

Therapist

Phone

(408) 972-3419

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shannon Barbara Michelson

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1114051679
  NPD (past) Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902933476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 5956",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95150",
            "telephone_number": "408-972-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 COTTLE RD",
            "address_2": "BUILDING 4",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95014",
            "telephone_number": "408-972-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER SANTA THERESA PSYCHIATRY DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICHELSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "408-972-3419",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "LCS21247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente Health
• Kaiser Permanente Santa Teresa
• Elizabeth D. E. Kaiser, MD
• Franz Nicholas Kaiser, M.D.
• Rabeha Kaiser, RDN
• Patricia Kakunted, MS,RD
• Maryam Kalami

• Health Maintenance Organization in San Jose, CA
• Providers in San Jose, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.