Amelia Gabrielle Jayanty, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33674 Issued in CA

Practice address

2940 Summit St Ste 2D
Oakland, CA 94609-3416

Phone

(713) 859-7703

NPI assigned

Aug 26, 2015

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 13, 2023 through Dec 13, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oakes Children's Center, Inc

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1932277308
  NPD (past)

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1174990063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2D",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "713-859-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2D",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "713-859-7703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Treat Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941105234",
            "country_code": "US",
            "telephone_number": "415-641-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYANTY",
        "first_name": "AMELIA",
        "middle_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33674",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Jaurigui
• Klyde Java
• Danilo Malabanan Javier, RN, PHN
• Jay West Physical Therapy Inc
• Amrita Jayagopal, RD, MA, CDE
• JC Wellness
• Jcares, Inc.
• Hurgues Jean-Charles
• Delano Gregory Jean-Pierre
• Jeanette Beer

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.