DR. THERESE MARIE RUSSI-SCHOU I PH.D.
NPI 1306203955
Psychologist in San Jose, CA

Active since January 26, 2016Opted out of Medicare · through Feb 23, 2027
1302 LINCOLN AVE, SAN JOSE, CA 95125(408) 471-6700 Get Directions Write a Review

NPPES record last updated: February 1, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 1, 2017, Jan 26, 2016 (2 updates tracked since 2016).

About Dr. Therese Marie Russi-schou I Ph.d. NPPES

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

DR. THERESE MARIE RUSSI-SCHOU I PH.D. (NPI 1306203955) is an individual psychologist in San Jose, California, licensed in California (PSY15359) and active in the NPI registry since January 2016. She has opted out of Medicare through February 23, 2027.

NPPES Registry Identity

NPI1306203955
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. THERESE MARIE RUSSI-SCHOU ICredential: PH.D.
Location Address1302 LINCOLN AVESan Jose, CA 95125-3015
Mailing AddressPo Box 6563San Jose, CA 95150-6563 · (408) 471-6700
Sole ProprietorYes
Enumeration DateJanuary 26, 2016
Last NPPES UpdateFebruary 1, 20172 updates tracked since enumeration
NPI 1306203955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY15359
Definition

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.

1302 LINCOLN AVE, San Jose, CA 95125

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Therese Marie Russi-schou I Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 23, 2023 through February 23, 2027.

Opt-Out Effective DateFebruary 23, 2023
Opt-Out In Effect ThroughFebruary 23, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1302 LINCOLN AVE, SUITE 203
SAN JOSE, CA 95125

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1306203955, enumerated as an "individual" on January 26, 2016.

The provider is located at 1302 LINCOLN AVE SAN JOSE, CA 95125 and the phone number is (408) 471-6700.

Psychologist with taxonomy code 103T00000X.