Individual provider Active NPI

Juanita M Dimas, PH.D.

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1316107774
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16051 Issued in CA
Practice address
4000 Broadway
Suite 1
Oakland, CA 94611-5670
Phone
(510) 769-2937
Fax
(510) 658-7533
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16051 CA Primary

Addresses

Primary practice location

4000 Broadway
Suite 1
Oakland, CA 94611-5670

Mailing address

4000 Broadway
Suite 1
Oakland, CA 94611-5670
Phone (510) 769-2937

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
I20091104000148 CA Practitioner - Clinical Psychologist 6800934365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY16051CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince May 31, 2019 Accepting new patients
Alameda Health System CurrentSince May 31, 2019 Accepting new patients
Alameda Health System Current Accepting new patients

Locations

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1316107774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 BROADWAY",
            "address_2": "SUITE 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115670",
            "telephone_number": "510-769-2937",
            "fax_number": "510-658-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BROADWAY",
            "address_2": "SUITE 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115670",
            "telephone_number": "510-769-2937",
            "fax_number": "510-658-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMAS",
        "first_name": "JUANITA",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.