DR. VIDHYA KRISHNAMURTHY PHD
NPI 1770776510
Psychologist - Clinical Child & Adolescent in San Bernardino, CA

Q: What is Vidhya Krishnamurthy's NPI number?

The NPI number for Vidhya Krishnamurthy is 1770776510. It was assigned to this individual provider in the NPPES registry on August 24, 2007.

Q: What is Vidhya Krishnamurthy's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Active since August 24, 2007PECOS Enrolled

2195 CLUB CENTER DR STE A, SAN BERNARDINO, CA 92408(909) 558-4000 Get Directions Write a Review

NPPES record last updated: January 20, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Dr. Vidhya Krishnamurthy Phd NPPES

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

DR. VIDHYA KRISHNAMURTHY PHD (NPI 1770776510) is an individual clinical child & adolescent provider in San Bernardino, California, licensed in California (PSY24993) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1770776510

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. VIDHYA KRISHNAMURTHYCredential: PHD

Location Address2195 CLUB CENTER DR STE ASan Bernardino, CA 92408-4162

Mailing Address2195 Club Center DrSan Bernardino, CA 92408-4170

Phone(909) 558-4000

Sole ProprietorNo

Enumeration DateAugust 24, 2007

Last NPPES UpdateJanuary 20, 2020

✔ NPI 1770776510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in CA · PSY24993

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License PSY24993 (CA)

2195 CLUB CENTER DR STE A, San Bernardino, CA 92408

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Secondary Practice Locations 2

Location 119314 Jesse Ln Ste 200Riverside, CA 92508-5070 · Phone (909) 799-3777

Location 21499 S Tippecanoe Ave Bldg ASan Bernardino, CA 92408-2920 · Phone (909) 799-3777

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Vidhya Krishnamurthy Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Vidhya Krishnamurthy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Faculty Physicians And Surgeons Of Llusm

Same address

Ophthalmology

2195 CLUB CENTER DR, SUITE A-L
San Bernardino, CA 92408

Reassigned Medicare billing, California enrollment
2,584 clinicians in this Medicare group

NPI 1962452714 (909) 558-2154

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

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

DR. HUA WANG M.D

Medical Genetics (Clinical Genetics (M.D.))