Individual provider Active NPI

Jason Samuel Middleton

  • Mental Health Counselor
  • Dublin, CA
National Provider Identifier
1255860847
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8555 Wicklow LN
Dublin, CA 94568-1145
Phone
(510) 925-8779
Fax
(510) 925-8779
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

8555 Wicklow LN
Dublin, CA 94568-1145

Mailing address

7200 Bancroft Ave Ste 133
Oakland, CA 94605-2480
Phone (510) 553-8500

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

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1255860847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 133",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052480",
            "telephone_number": "510-553-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 WICKLOW LN",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945681145",
            "telephone_number": "510-925-8779",
            "fax_number": "510-925-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "JASON",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.