John Alexander Gillean, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A141657 Issued in CA

Practice address

55 Santa Clara Ave Ste 171
Oakland, CA 94610-1333

Phone

(510) 541-2323

Fax

(510) 907-7966

NPI assigned

Oct 13, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jack Gillean Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Innerspace Psychiatry PC

  • Psychiatry Physician
  • Oakland, CA
  • NPI 1821880212
  NPD Authorized official

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1528378460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SANTA CLARA AVE STE 171",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101333",
            "telephone_number": "510-541-2323",
            "fax_number": "510-907-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SANTA CLARA AVE STE 171",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101333",
            "telephone_number": "510-541-2323",
            "fax_number": "510-907-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEAN",
        "first_name": "JOHN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0054348",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A141657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "GILLEAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aditya Gill, MD
• Tanya N. Gill, O.D.
• Afroza Gillani
• Tia R Gillard
• Meriah R Gille, R.D.
• Spencer Gilles
• Gillian Edna Gillette, LMFT
• Zehna Gilliam
• Kathleen Jan Gillis, RN MSN FNP
• Shivani Gillon, MD

• Psychiatry Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.