Kathryn Alice Jackson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

7016 Issued in MA

Practice address

45 Winslow St
Cambridge, MA 02138

Phone

(617) 492-1942

NPI assigned

Mar 25, 2007

Sex

Female

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

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1104943901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WINSLOW ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021386728",
            "telephone_number": "617-492-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WINSLOW ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-492-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHRYN",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zainab Susan Jabur, MD, MPH
• Joanne S Jack, FNP
• Shawn Jackson Dupuy, D.C.
• Doris A Jackson, PHD
• Joseph Alexander Jackson IV, D.O.
• Latoya Shari Jackson, M.D.
• Maggie Virginia Jackson, MSW
• Rose M Jacob, RN
• Irene A. Jacobs, PHD
• Bryce Jacobson, PSYD

• Psychologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.