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RAVEN CROSS
NPI 1114596624
Nurse Practitioner - Psychiatric/Mental Health in San Jose, CA

Active since June 18, 2021PECOS Enrolled
1165 LINCOLN AVE STE 150, SAN JOSE, CA 95125(408) 372-8580 Get Directions Write a Review

NPPES record last updated: May 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 25, 2023, Jan 31, 2022, Jun 18, 2021 (3 updates tracked since 2021).

About Raven Cross NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN CROSS (NPI 1114596624) is an individual psychiatric/mental health provider in San Jose, California, licensed in California (95019647) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114596624
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameRAVEN CROSS
Location Address1165 LINCOLN AVE STE 150San Jose, CA 95125-3045
Mailing Address1165 Lincoln Ave Ste 150San Jose, CA 95125-3045
Phone(408) 372-8580
Sole ProprietorYes
Enumeration DateJune 18, 2021
Last NPPES UpdateMay 25, 20233 updates tracked since enumeration
NPPES CertifiedMay 25, 2023
✔ NPI 1114596624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in CA · 95019647✔ Licensed in VA · 0024183375
Also ListedRegistered Nurse · Psychiatric/Mental Health, Child & AdolescentTaxonomy 163WP0807X · License 95142217 (CA)
1165 LINCOLN AVE STE 150, San Jose, CA 95125
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raven Cross is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95125 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Raven Cross's NPI number?

The NPI number for Raven Cross is 1114596624. It was assigned to this individual provider in the NPPES registry on June 18, 2021.

Where is Raven Cross located?

Raven Cross practices at 1165 Lincoln Ave Ste 150, San Jose, CA 95125. The listed phone number is (408) 372-8580.

What is Raven Cross's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Raven Cross enrolled in Medicare?

Yes. Raven Cross is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Raven Cross was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.