Active NPI
Jack Philip Pascoe, PSY.D.
- Clinical Psychologist
- Grass Valley, CA
National Provider Identifier
1386816452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY6959
- Practice address
- 14137 Dalmatian Dr
Grass Valley, CA 95945-9679 - Phone
- (530) 320-2119
- Fax
- (530) 477-2435
- NPI assigned
- Mar 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY6959 | CA | Primary |
Addresses
Primary practice location
14137 Dalmatian Dr
Grass Valley, CA 95945-9679
Mailing address
PO Box 614
Cedar Ridge, CA 95924-0614
Phone (530) 320-2119
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6959 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206748800000",
"number": "1386816452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 614",
"city": "CEDAR RIDGE",
"state": "CA",
"postal_code": "959240614",
"telephone_number": "530-320-2119",
"fax_number": "530-477-2435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14137 DALMATIAN DR",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459679",
"telephone_number": "530-320-2119",
"fax_number": "530-477-2435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASCOE",
"first_name": "JACK",
"middle_name": "PHILIP",
"name_prefix": "Mr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-29",
"last_updated": "2008-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY6959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.