Individual provider Active NPI

Carol Marie Skuletich-Vetter

  • Mental Health Counselor
  • San Jose, CA
National Provider Identifier
1962712497
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2001 The Alameda
San Jose, CA 95126-1136
Phone
(408) 261-7777
Fax
(408) 254-9960
NPI assigned
Oct 18, 2010
Last updated
Oct 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2001 The Alameda
San Jose, CA 95126-1136

Mailing address

910 Rockefeller Dr
Apt 7B
Sunnyvale, CA 94087-2169
Phone (408) 307-1930

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

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1962712497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 ROCKEFELLER DR",
            "address_2": "APT 7B",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872169",
            "telephone_number": "408-307-1930",
            "fax_number": "408-296-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-254-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKULETICH-VETTER",
        "first_name": "CAROL",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.