MOMENTUM FOR MENTAL HEALTH (NPI# 1275176265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275176265 |
| Entity Type | Organization |
| Organization Name | MOMENTUM FOR MENTAL HEALTH |
| Other Organization Name | MOMENTUM FOR MENTAL HEALTH IFSP-ADULT / IFSP-TAY |
| Practice Address |
2115 The Alameda San Jose CA 95126-1141 |
| Mailing Address |
2001 The Alameda San Jose CA 95126-1136 |
| Practice Telephone | 4086426053 |
| Practice Fax Number | 4086426076 |
| Mailing Telephone | 4086426073 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2020-10-29 |
| Authorized Official Name | KEVIN DEWITT (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4086426053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | ZZZ01125Z | 01 |
| Other Name | Type Code |
|---|---|
| Momentum for Mental Health IFSP-Adult / IFSP-TAY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922300128 | Momentum for Mental Health | Psychologist | 185 Martinvale Ln, San Jose, CA 95119-1319 | 2010-11-22 |
| 1861702995 | Momentum for Mental Health | Community/Behavioral Health | 2001 The Alameda, San Jose, CA 95126-1136 | 2010-10-07 |
| 1538477948 | Momentum for Mental Health | Community/Behavioral Health | 2001 The Alameda, San Jose, CA 95126-1136 | 2010-09-20 |
| 1700037470 | Momentum for Mental Health | Community/Behavioral Health | 2001 The Alameda, San Jose, CA 95126-1136 | 2008-09-30 |
| 1154426807 | Momentum for Mental Health | Psychologist | 2001 The Alameda, San Jose, CA 95126-1136 | 2006-09-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MOMENTUM FOR MENTAL HEALTH | 17971 E State Route 106, Belfair, WA 98528-8509 |
| System for Award Management (SAM) Entities | MOMENTUM FOR MENTAL HEALTH | 438 N White Rd, San Jose, CA 95127-1439 |
| Street Address |
2115 THE ALAMEDA |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95126-1141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811193063 | Council On Aging, Silicon Valley | Case Management | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-06-25 |
| 1598196651 | Sourcewise | Case Management | 2115 The Alameda, San Jose, CA 95126-1141 | 2013-11-27 |
| 1245477645 | Bethany Pounders | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2009-01-07 |
| 1982855425 | Aisha Richards | Community Health Worker | 2115 The Alameda, San Jose, CA 95126-1141 | 2008-10-02 |
| 1811148356 | Bhairavi Kothare | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2008-10-02 |
| 1942483169 | Gloria Karina Marroquin | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-12-11 |
| 1922281146 | Jessica Kim Nguyen | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-12-11 |
| 1316120637 | Kimberly Spelce | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-12-10 |
| 1861675191 | Nancy Kwong | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-12-10 |
| 1063695385 | Erica Maria Escalante | Case Manager/Care Coordinator | 2115 The Alameda, San Jose, CA 95126-1141 | 2007-12-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356830418 | Esperanza Maravilla | Counselor | 1259 Park Ave, Apt 15, San Jose, CA 95126 | 2018-05-04 |
| 1811417819 | Sahr Lawande | Occupational Therapist | 1373 University Ave, San Jose, CA 95126 | 2017-06-21 |
| 1063941482 | Yang Li | Acupuncturist | 1520 Southwest Expy Unit 141, San Jose, CA 95126 | 2017-06-08 |
| 1598294860 | Camille Campbell | Counselor | 1400 Parkmoor Avenue, Suite 115, San Jose, CA 95126 | 2017-06-08 |
| 1588193387 | Vanessa Aspera | Case Manager/Care Coordinator | 1400 Parkmoor Avenue, San Jose, CA 95126 | 2017-06-06 |
| 1538692603 | Alexa Stine Fields | Acupuncturist | 714 Harding Ave, San Jose, CA 95126 | 2017-04-06 |
| 1669903647 | Lillette Rosete | Assisted Living Facility | 960 Vermont St, San Jose, CA 95126 | 2017-03-22 |
| 1952847105 | Dana Ninkham | Behavior Technician | 1922 The Alameda Suite 425, San Jose, CA 95126 | 2017-01-12 |
| 1811441199 | Cristina Morales Delgado | Community Health Worker | 1400 Parkmore Avenue, Suite 115, San Jose, CA 95126 | 2016-08-04 |
| 1053770123 | Felicia Nibungco | Marriage & Family Therapist | 1922 The Alameda Ste 326, San Jose, CA 95126 | 2016-02-18 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548896236 | Gregory P. Salerno, Ph.d., A Psychology Corporation | Psychologist | 390 Spar Ave Ste 205, San Jose, CA 95117-1644 | 2020-03-13 |
| 1548766454 | Jenifer Miri | Psychologist | 6370 Mojave Dr, San Jose, CA 95120-5310 | 2018-04-01 |
| 1417460676 | Belinda Sangrat | Psychologist | 275 Hospital Pkwy Ste 370, San Jose, CA 95119-1136 | 2017-11-09 |
| 1659818060 | Kathlyn Clementelli | Psychologist | 3212 Tenley Dr, San Jose, CA 95148-3639 | 2017-01-23 |
| 1932650223 | Lorena Ho | Psychologist | 199 Laurel Grove Ln, San Jose, CA 95126-4848 | 2016-10-20 |
| 1477906410 | Momentum for Mental Health - Crisis Stabilization | Psychologist | 101 Jose Figueres Ave Ste 50, San Jose, CA 95116-2022 | 2016-07-14 |
| 1215388764 | Momentum for Mental Health - Cr | Psychologist | 101 Jose Figueres Ave Ste 10, San Jose, CA 95116-2022 | 2016-06-27 |
| 1306214325 | Amanda Montgomery | Psychologist | 4300 Stevens Creek Blvd Ste 260, San Jose, CA 95129 | 2015-09-08 |
| 1386046258 | Nicole Dow | Psychologist | 1417 Allegado Aly, San Jose, CA 95128-4547 | 2014-09-22 |
| 1902219850 | Rohn Taylor Stark Jr. | Psychologist | 150 Palm Valley Blvd, 3128, San Jose, CA 95123-1060 | 2014-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.