DR. JASEON S. OUTLAW (NPI# 1861747552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861747552 |
| Entity Type | Individual |
| Full Name | DR. JASEON S. OUTLAW |
| Credential | PHD |
| Practice Address |
13847 E 14th St Ste 202 San Leandro CA 94578-2626 |
| Practice Telephone | 5104631302 |
| Mailing Telephone | 5104631302 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2016-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY23676 | CA | Behavioral Health & Social Service Providers |
| Street Address |
13847 E 14TH ST STE 202 |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073122958 | Journey of Life Psychological, Inc. | Clinic/Center | 13847 E 14th St Ste 202, San Leandro, CA 94578-2626 | 2020-07-28 |
| 1639701857 | Journey To New Beginnings | Clinic/Center | 13847 E 14th St Ste 202, San Leandro, CA 94578-2626 | 2020-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831380146 | Mary Marth | Psychologist | 2500 Fairmont Drive, Guidance Clinic, San Leandro, CA 94578 | 2007-08-05 |
| 1982803169 | Kambiz Sakhai | Psychologist | 303 W Joaquin Ave Ste 100, San Leandro, CA 94577-3667 | 2007-07-17 |
| 1457559569 | Wana Shirgul Salehi | Psychologist | 2418 Fairway Dr, San Leandro, CA 94577-5411 | 2007-07-10 |
| 1932304052 | Myron John Gulseth | Psychologist | 13851 East 14th Street, Suite 203, San Leandro, CA 94578 | 2007-06-19 |
| 1114130978 | Erica Wandner | Psychologist | 13666 East 14th St, San Leandro, CA 94578 | 2007-05-08 |
| 1538204847 | Lori Ann Spampinato | Psychologist | 15250 Hesperian Blvd Ste 100, San Leandro, CA 94578-3962 | 2007-02-21 |
| 1649336793 | Rosemarie Ratto | Psychologist | 345 Estudillo Ave Ste 207, San Leandro, CA 94577-4727 | 2006-12-30 |
| 1578633491 | Joanna L Zygmont | Psychologist | 400 Estudillo Ave Ste 201, San Leandro, CA 94577-4900 | 2006-11-08 |
| 1922023241 | Ida M. Roberts | Psychologist | 433 Callan Ave, Ste 203, San Leandro, CA 94577-4643 | 2006-07-13 |
| 1861017097 | Elena Duong | Psychologist | 777 Davis St, San Leandro, CA 94577-6923 | 2020-06-12 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
Please comment or provide details below to improve the information on DR. JASEON S. OUTLAW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.