Individual provider Active NPI

Jamie Higgins Edmund, PHD

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1104109461
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10785 Issued in CA
Practice address
5655 College Ave
#300
Oakland, CA 94618-1583
Phone
(510) 547-8450
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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 PSY10785 CA Primary

Addresses

Primary practice location

5655 College Ave
#300
Oakland, CA 94618-1583

Mailing address

5655 College Ave
#300
Oakland, CA 94618-1583
Phone (510) 547-8450

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY10785CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1104109461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 COLLEGE AVE",
            "address_2": "#300",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181583",
            "telephone_number": "510-547-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 COLLEGE AVE",
            "address_2": "#300",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181583",
            "telephone_number": "510-547-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUND",
        "first_name": "JAMIE",
        "middle_name": "HIGGINS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.