Healthcare Provider Details

I. General information

NPI: 1205528981
Provider Name (Legal Business Name): SHEREEN MOHSEN PSYCHOLOGY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S WINCHESTER BLVD STE J205
SAN JOSE CA
95128-3918
US

IV. Provider business mailing address

1101 S WINCHESTER BLVD STE A101
SAN JOSE CA
95128-3914
US

V. Phone/Fax

Practice location:
  • Phone: 408-680-4114
  • Fax:
Mailing address:
  • Phone: 408-680-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHEREEN MOHSEN
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSY.D.
Phone: 408-680-4114