DISRUPTIVE THERAPY COLLECTIVE FOR THE INDIVIDUAL, FAMILY, AND CHILD
NPI 1083392302
Clinic/Center - Mental Health (Including Community Mental Health Center) in San Jose, CA
About Disruptive Therapy Collective For The Individual, Family, And Child NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DISRUPTIVE THERAPY COLLECTIVE FOR THE INDIVIDUAL, FAMILY, AND CHILD (NPI 1083392302), doing business as Disruptive Therapy Collective, is a healthcare organization registered as a mental health (including community mental health center) in San Jose, California and active in the NPI registry since July 2023. The organization lists Alice Bui, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Disruptive Therapy Collective For The Individual, Family, And Child is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Disruptive Therapy Collective For The Individual, Family, And Child, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Disruptive Therapy Collective For The Individual, Family, And Child's NPI number?
The NPI number for Disruptive Therapy Collective For The Individual, Family, And Child is 1083392302. It was assigned to this organization in the NPPES registry on July 6, 2023. The provider is doing business as Disruptive Therapy Collective.
Where is Disruptive Therapy Collective For The Individual, Family, And Child located?
Disruptive Therapy Collective For The Individual, Family, And Child is located at 1769 Park Ave Ste 250, San Jose, CA 95126. The listed phone number is (408) 365-4238.
What is Disruptive Therapy Collective For The Individual, Family, And Child's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Disruptive Therapy Collective For The Individual, Family, And Child enrolled in Medicare?
Yes. Disruptive Therapy Collective For The Individual, Family, And Child is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Disruptive Therapy Collective For The Individual, Family, And Child?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Marriage and Family Therapist) reassigns their Medicare billing to Disruptive Therapy Collective For The Individual, Family, And Child. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Disruptive Therapy Collective For The Individual, Family, And Child was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Disruptive Therapy Collective For The Individual, Family, And Child · NPI 1083392302
Mental Health (Including Community Mental Health Center) organization in San Jose, California. Organization record, active in the CMS NPPES registry since July 6, 2023.
## Identity
- **NPI:** 1083392302 (Entity type: Organization)
- **Enumerated:** July 6, 2023
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Also known as:** Disruptive Therapy Collective (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Alice Bui, CEO
## Practice location
- **Address:** 1769 PARK AVE STE 250, San Jose, CA 95126-2030
- **Phone:** (408) 365-4238
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Marriage and Family Therapist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1083392302) · Data from the CMS NPPES public registry.