DR. JACOB JOHN MAHON (NPI# 1912143306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912143306 |
| Entity Type | Individual |
| Full Name | DR. JACOB JOHN MAHON |
| Credential | PHD; BCBA-D |
| Practice Address |
1744 E Mcandrews Rd Ste B Medford OR 97504-5576 |
| Practice Telephone | 5416541776 |
| Mailing Telephone | 5417760821 |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2019-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3067 | OR | Behavioral Health & Social Service Providers |
| N | 103TH0100X |
Psychologist Specialization: Health Service |
3067 | OR | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1255 Cal Young Rd, Eugene, OR 974011874 | 5416541776 |
| Street Address |
1744 E MCANDREWS RD STE B |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-5576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952813610 | Julie Newman | Nurse Practitioner | 1744 E Mcandrews Rd Ste B, Medford, OR 97504-5576 | 2017-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639958 | Steven C Schoger Psy D LLC | Psychologist | 10 Crater Lake Ave Ste 21, Medford, OR 97504-7445 | 2019-09-29 |
| 1578925947 | Linda Shane Escoll | Psychologist | 120 Curtis St, Counseling and Mental Health Service, Tufts University, Medford, MA 02155 | 2016-03-24 |
| 1033576723 | Nicole Paolillo | Psychologist | 2 Persimmon Ct, Medford, NJ 08055-3605 | 2016-01-26 |
| 1275929630 | Lizabeth M. Eckerd | Psychologist | 4497 Brown Ridge Ter Ste 106, Medford, OR 97504-9173 | 2015-04-13 |
| 1407265176 | Vicki Lumley, Ph.d., LLC | Psychologist | 724 South Central Ave., Suite 101, Medford, OR 97501-7851 | 2014-08-07 |
| 1144463845 | Boyd David Sherbourne | Psychologist | 670 Superior Ct Ste 110, Medford, OR 97504-6179 | 2009-04-09 |
| 1750550687 | Joseph F Roe | Psychologist | 136 W Broadway Ave, Medford, WI 54451-1757 | 2008-02-25 |
| 1396942025 | Alan Ledford | Psychologist | 409 Ardmore Ave, Medford, OR 97504-8004 | 2007-06-27 |
| 1225247653 | Wade W Johnston | Psychologist | 603 Eugenia Drive, Medford, NJ 08055-2311 | 2007-05-22 |
| 1336364066 | Karen Hagerman Muller | Psychologist | 4497 Brown Ridge Ter Ste 104, Medford, OR 97504-9173 | 2007-04-16 |
| Find all providers in MEDFORD | ||||
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| 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.