Individual provider Active NPI

Jason Tinero

  • Clinical Child & Adolescent Psychologist
  • Palo Alto, CA
National Provider Identifier
1255919155
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
650 Clark Way
Palo Alto, CA 94304-2300
Phone
(650) 326-5530
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

650 Clark Way
Palo Alto, CA 94304-2300

Mailing address

1430 Gordon St Apt D
Redwood City, CA 94061-2755
Phone (818) 294-3154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524002724 CA Practitioner - Clinical Psychologist 5698117430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
34505CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Single Specialty Current Accepting new patients
UCSF Medical Group Business Services Single Specialty CurrentSince Apr 26, 2024 Accepting new patients
UCSF Psychiatry Single Specialty CurrentSince Apr 26, 2024 Accepting new patients
University of California San Francisco CurrentSince Apr 26, 2024 Accepting new patients
University of California San Francisco Single Specialty CurrentSince Apr 26, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Apr 26, 2024 Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

401 Parnassus Ave
#984
San Francisco, CA 94143
Phone (415) 476-7527

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

675 18th St
#5250
San Francisco, CA 94143
Phone (415) 502-2413

675 18th St
Ste PB5250
San Francisco, CA 94143

401 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-7500

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1255919155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 GORDON ST APT D",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940612755",
            "telephone_number": "818-294-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CLARK WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042300",
            "telephone_number": "650-326-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINERO",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.