Active NPI
Jason Amed Richardson
- Psychologist
- Oceanside, CA
National Provider Identifier
1003135666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 24583
- Practice address
- 1738 S Tremont St
Oceanside, CA 92054-5309 - Phone
- (760) 439-2800
- NPI assigned
- May 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 24583 | CA | Primary |
Addresses
Primary practice location
1738 S Tremont St
Oceanside, CA 92054-5309
Mailing address
2734 Loker Ave W
Suite L
Carlsbad, CA 92010-6627
Phone (760) 230-4274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 24583 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Boston, MA
- NPI 1740860428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1003135666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2734 LOKER AVE W",
"address_2": "SUITE L",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920106627",
"telephone_number": "760-230-4274",
"fax_number": "760-230-4274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1738 S TREMONT ST",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920545309",
"telephone_number": "760-439-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "JASON",
"middle_name": "AMED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-21",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 24583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.