Active NPI
Jae Douglas Truesdell, MA, MPH, CMPSS
- Peer Specialist
- San Leandro, CA
National Provider Identifier
1174337703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-YQHUXN
- Practice address
- 15200 Foothill Blvd
San Leandro, CA 94578-1013 - Phone
- (510) 352-9690
- NPI assigned
- Feb 4, 2025
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-YQHUXN | CA | Primary |
Addresses
Primary practice location
15200 Foothill Blvd
San Leandro, CA 94578-1013
Mailing address
15200 Foothill Blvd
San Leandro, CA 94578-1013
Phone (510) 352-9690
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-YQHUXN | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1174337703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15200 FOOTHILL BLVD",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781013",
"telephone_number": "510-352-9690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15200 FOOTHILL BLVD",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781013",
"telephone_number": "510-352-9690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUESDELL",
"first_name": "JAE",
"middle_name": "DOUGLAS",
"credential": "MA, MPH, CMPSS",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-02-04",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-YQHUXN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.