Individual provider Active NPI

Daniel Stone Jaquette, EDD

  • Psychologist
  • Wellesley, MA
National Provider Identifier
1396712204
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2610 Issued in MA
Practice address
11 River Street
Wellesley, MA 02481-2098
Phone
(781) 431-1177
Fax
(781) 431-1181
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2610 MA Primary

Addresses

Primary practice location

11 River Street
Wellesley, MA 02481-2098

Mailing address

11 River Street
Wellesley, MA 02481-2098
Phone (781) 431-1177

Other identifiers 2

IdentifierTypeStateIssuer
732754OtherMATUFTS HEALTH
001844OtherMAHARVARD PILGRIM

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396712204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RIVER STREET",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812098",
            "telephone_number": "781-431-1177",
            "fax_number": "781-431-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RIVER STREET",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812098",
            "telephone_number": "781-431-1177",
            "fax_number": "781-431-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUETTE",
        "first_name": "DANIEL",
        "middle_name": "STONE",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH",
            "identifier": "732754",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "001844",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.