Psychelogik Psychological, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCHELOGIK PSYCHOLOGICAL, INC.

Practice address

2020 Forest Ave Ste 3
San Jose, CA 95128-4805

Phone

(408) 409-3964

Fax

(408) 295-8818

NPI assigned

Nov 23, 2021

Organization subpart

No

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

Authorized official

Name

Kate Young, PHD

Title

Owner

Phone

(408) 409-3964

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1912664178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 FOREST AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284805",
            "telephone_number": "408-409-3964",
            "fax_number": "408-295-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 FOREST AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284805",
            "telephone_number": "408-409-3964",
            "fax_number": "408-295-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHELOGIK PSYCHOLOGICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-409-3964",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Kristine Provenzano, D.D.S.
• Janelle Provost, DC
• Alysha Prum
• Chettra So Prum
• Phyllis Lynn Pryor
• PT2 Physical & Sports Therapy Inc.
• Nestor Puente
• Rosario Puga-Dempsey
• Lurdez Puga
• Adilenne Pulido

• Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.