Active NPI
Jeremy Thomas Simpkin, MFT
- Marriage & Family Therapist
- Berkeley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 103287
- Practice address
- 2636 Martin Luther King Jr Way
Berkeley, CA 94704-3238 - Phone
- (510) 981-6583
- NPI assigned
- Jan 25, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 103287 | CA | Primary |
Addresses
Primary practice location
2636 Martin Luther King Jr Way
Berkeley, CA 94704-3238
Mailing address
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 317-1444
Other practice location 1
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 317-1444
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103287 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Grow Healthcare Group PC | Marriage & Family Therapist | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 4
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.
-
- Mental Health Counselor
- San Jose, CA
- NPI 1154994846
Marriage & Family Therapist
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Hawthorne, CA
- NPI 1164914115
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1265899025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132",
"telephone_number": "510-317-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2636 MARTIN LUTHER KING JR WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043238",
"telephone_number": "510-981-6583"
}
],
"practiceLocations": [
{
"address_1": "2275 Arlington Dr",
"address_purpose": "LOCATION",
"city": "San Leandro",
"state": "CA",
"postal_code": "945781132",
"country_code": "US",
"telephone_number": "510-317-1444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMPKIN",
"first_name": "JEREMY",
"middle_name": "THOMAS",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-25",
"last_updated": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "103287",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "710 S Broadway",
"city": "Walnut Creek",
"state": "CA",
"country_code": "US",
"postal_code": "945965294",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.