Jason Paul Karageorge, PHD
Individual provider Active NPI Psychologist · Nicasio, CA
NPI 1649576166 · NPPES record last updated Jan 3, 2022
Key facts
- NPI
- 1649576166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 24025 (CA)
- Practice address
- 7349 Lucas Valley Rd
Nicasio, CA 94946-9720 - Phone
- (415) 385-2847
- NPI assigned
- Jan 31, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131106000920 | CA | Practitioner - Clinical Psychologist | 4082849609 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24025 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current |
Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785
1400 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-4338
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 24025 | CA | Yes |
Addresses
Primary practice location
7349 Lucas Valley Rd
Nicasio, CA 94946-9720
Mailing address
7349 Lucas Valley Rd
Nicasio, CA 94946-9720
Phone (415) 385-2847
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Nicasio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.