Jamaal R Tibbs

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW98007 Issued in CA

Practice address

1486 Huntington Ave Ste 100
South San Francisco, CA 94080-5971

Phone

(650) 877-8642

NPI assigned

Dec 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Youth Service Bureau of the YMCA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South San Francisco, CA
  • NPI 1235712837
  NPD

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1023613775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 FILLMORE ST STE 303",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941154164",
            "telephone_number": "415-637-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 HUNTINGTON AVE STE 100",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805971",
            "telephone_number": "650-877-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "JAMAAL",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW98007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Thierer, DO
• Llewellyn Thompson III, PTA
• Neomiah Thompson
• Anthony Tun Thu, MD
• Dirk Anders Thye, MD
• Suvi Tikka Silvanto
• Maung Tin, MD
• Ruth Tinetti
• Angelica Regalado Tinio, RN
• Vivian Veronica Tisi, MA, CCC-SLP

• Mental Health Counselor in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.