Individual provider Active NPI

Douglas K Jameson Jr., PSY.D

  • Clinical Psychologist
  • Berkeley, CA
National Provider Identifier
1023031515
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19189 Issued in CA
Practice address
3167 College Ave
Berkeley, CA 94705-2755
Phone
(510) 301-2712
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY19189 CA Primary

Addresses

Primary practice location

3167 College Ave
Berkeley, CA 94705-2755

Mailing address

6856 Armour Dr
Oakland, CA 94611-1316
Phone (510) 339-3643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1023031515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 ARMOUR DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111316",
            "telephone_number": "510-339-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3167 COLLEGE AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052755",
            "telephone_number": "510-301-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMESON",
        "first_name": "DOUGLAS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.