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DR. ROBERTA BASSETT CORSON PH.D.
NPI 1881802080
Psychologist - Adult Development & Aging in San Jose, CA

Active since May 19, 2007Opted out of Medicare · through Jul 1, 2028
4010 MOORPARK AVE, SUITE 206, SAN JOSE, CA 95117(408) 247-1774 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Dr. Roberta Bassett Corson Ph.d. NPPES

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

DR. ROBERTA BASSETT CORSON PH.D. (NPI 1881802080) is an individual adult development & aging provider in San Jose, California, licensed in California (PSY18128) and active in the NPI registry since May 2007. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1881802080
Entity TypeIndividualFemale
Primary Taxonomy103TA0700X
Provider Legal NameDR. ROBERTA BASSETT CORSONCredential: PH.D.
Location Address4010 MOORPARK AVE, SUITE 206San Jose, CA 95117-4101
Mailing Address4010 Moorpark Ave, Suite 206San Jose, CA 95117-4101 · (408) 247-1774
Phone(408) 247-1774
Sole ProprietorYes
Enumeration DateMay 19, 2007
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1881802080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · Adult Development & AgingBehavioral Health & Social Service Providers
Taxonomy Code103TA0700X
License✔ Licensed in CA · PSY18128
Definition
A psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY18128 (CA)
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License PSY18128 (CA)

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. Roberta Bassett Corson 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 July 1, 2016 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2016
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 12

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

LIANA MEHAWEJ CCC-SLP
Speech-Language Pathologist
4010 MOORPARK AVE, SUITE 117
SAN JOSE, CA 95117
Santa Clara County (408) 249-0770
SEAN LEWIS HODSON AMFT
Marriage & Family Therapist
4010 MOORPARK AVE
SAN JOSE, CA 95117
Santa Clara County (650) 297-3400
MERLIN ELIZABETH CHERIAN
Speech-Language Pathologist
4010 MOORPARK AVE
SAN JOSE, CA 95117
Santa Clara County (408) 249-0770
ALICIA TEETER CCC
Speech-Language Pathologist
4010 MOORPARK AVE, 117
SAN JOSE, CA 95117
Santa Clara County (408) 249-0770
SHARON SPIELER M.S., SLP
Speech-Language Pathologist
4010 MOORPARK AVE, 117
SAN JOSE, CA 95117
Santa Clara County (408) 249-0770
MS. KAREN YVONNE TAYLOR MFC
Marriage & Family Therapist
4010 MOORPARK AVE, SUITE 118
SAN JOSE, CA 95117
Santa Clara County (408) 455-8220
MARI-ELENA DURAND
Speech-Language Pathologist
4010 MOORPARK AVE, 117
SAN JOSE, CA 95117
Santa Clara County (408) 249-0770
GESINA PAGAN SLP
Speech-Language Pathologist
4010 MOORPARK AVE, 117
SAN JOSE, CA 95117
Santa Clara County (208) 249-0770

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 Roberta Corson's NPI number?

The NPI number for Roberta Corson is 1881802080. It was assigned to this individual provider in the NPPES registry on May 19, 2007.

Where is Roberta Corson located?

Roberta Corson practices at 4010 Moorpark Ave Suite 206, San Jose, CA 95117. The listed phone number is (408) 247-1774.

What is Roberta Corson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Adult Development & Aging, with taxonomy code 103TA0700X.

Is Roberta Corson enrolled in Medicare?

No. Roberta Corson has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Roberta Corson was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.