Individual provider Active NPI

Jamie L Mishler, PSY.D.

  • Clinical Psychologist
  • Victorville, CA
National Provider Identifier
1487883864
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26435 Issued in CA
Practice address
Behavioral Health Consultants
15434 Sage St
Victorville, CA 92392
Phone
(760) 843-0506
Fax
(661) 868-6666
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X PSY26435 CA
Clinical Psychologist 103TC0700X PSY26435 CA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X

Addresses

Primary practice location

Behavioral Health Consultants
15434 Sage St
Victorville, CA 92392

Mailing address

3403 10TH St
Ste 605
Riverside, CA 92501
Phone (909) 201-7786

Other names 1

  • Ms. Jamie Lewis Dutton Former name

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
I20220705001837 CA Practitioner - Clinical Psychologist 9133509466 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26435CAMDClinical Psychologist
26435CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Savanna Olsson, Pmhnp: a Professional Nursing Corporation CurrentSince Jul 3, 2022 Accepting new patients
Sud Specialty Group - Ca Addiction (Substance Use Disorder) CurrentSince Aug 1, 2025 Accepting new patients
Foothill Behavioral Health Consultants Inc CurrentSince May 1, 2022 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

15434 W Sage St
Victorville, CA 92392
Phone (760) 563-2875

15434 W Sage St
Ste 101
Victorville, CA 92392
Phone (760) 843-0506

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.

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1487883864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 10TH ST",
            "address_2": "STE 605",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92501",
            "telephone_number": "909-201-7786",
            "fax_number": "661-868-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH CONSULTANTS",
            "address_2": "15434 SAGE ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "760-843-0506",
            "fax_number": "661-868-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHLER",
        "first_name": "JAMIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY26435",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26435",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "DUTTON",
            "middle_name": "LEWIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.