Organization Active NPI

Pranamind LLC

Doing business as Prana Mind Center

  • Clinical Neuropsychologist
  • Oakland, CA
National Provider Identifier
1558994277
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
PRANAMIND LLC
Doing business as
Prana Mind Center
Practice address
459 W Macarthur Blvd
Oakland, CA 94609-2808
Phone
(877) 459-6463
Fax
(877) 459-6463
NPI assigned
Feb 21, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Dr. Paul Jackson, PH. D.NPI 1477112522
Title
Clinical Director
Phone
(877) 459-6463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

459 W Macarthur Blvd
Oakland, CA 94609-2808

Mailing address

459 W Macarthur Blvd
Oakland, CA 94609-2808
Phone (877) 459-6463

Other names 1

  • Prana Mind Center Doing business as

National Provider Directory

National Provider Directory

Locations

459 W MacArthur Blvd
Oakland, CA 94609
Phone (510) 450-1830

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1558994277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092808",
            "telephone_number": "877-459-6463",
            "fax_number": "877-459-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092808",
            "telephone_number": "877-459-6463",
            "fax_number": "877-459-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANAMIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "877-459-6463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prana Mind Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prana Mind Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.