Jenifer E. Dahlstrom, MFT, CEAP, SAP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

30247 Issued in CA

Practice address

492 Clifton St
Oakland, CA 94618-1162

Phone

(510) 273-9261

Fax

(510) 653-8787

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jenifer E. Bamberger Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 2, 2024 through Feb 2, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477587046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 CLIFTON STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94618",
            "telephone_number": "510-273-9261",
            "fax_number": "510-653-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 CLIFTON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181162",
            "telephone_number": "510-273-9261",
            "fax_number": "510-653-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLSTROM",
        "first_name": "JENIFER",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "MFT, CEAP, SAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "30247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENIFER",
            "last_name": "BAMBERGER",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leah Daffner, ASW
• Delia B. Dagumo-Amaral
• Natasha Dagys Pajoluk, M.A.
• Philip Dah
• Kramer Dahl
• Marian Ellen Dahmer, P.A.
• Matthew H Dahnke, M.D.
• Carmen Dayana Dahujan
• Xiaojun Dai
• Aurora G Daigle, ATR-P

• Mental Health Counselor in Oakland, CA
• Providers in Oakland, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.