Jacqueline J Head, PSY.D. PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1328 Issued in OR

Practice address

22344 SW Main St
Sherwood, OR 97140-9416

Phone

(503) 625-2768

Fax

(503) 625-3768

NPI assigned

Nov 30, 2005

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

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jacqueline J Head PSYD PC

  • Clinical Psychologist
  • Sherwood, OR
  • NPI 1528086055
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1639153125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22344 SW MAIN ST",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409416",
            "telephone_number": "503-625-2768",
            "fax_number": "503-625-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22344 SW MAIN ST",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409416",
            "telephone_number": "503-625-2768",
            "fax_number": "503-625-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "JACQUELINE",
        "middle_name": "J",
        "credential": "PSY.D.  PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Evan Hall, MD
• Dareen S Haniyah, RN
• Justin Harle, P.T.
• Nellab Hashimi, DDS
• Margaret Rose Havlik, ND
• Healing Therapy Solutions LLC
• Jaclyn Heintz, LMT
• Hailey Marie Hepperle
• Savannah Irene Heugly, DC, MS
• Erin Kaye Hewitt, PHARMD

• Clinical Psychologist in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.