Jon Joseph Cisneros, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3354 Issued in OR

Practice address

151 NW Monroe Ave Ste 103
Corvallis, OR 97330-4708

Phone

(541) 517-4542

NPI assigned

Nov 20, 2018

Last updated

Oct 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Corvallis Clinic P C

  • Multi-Specialty Clinic/Center
  • Corvallis, OR
  • NPI 1649227265
  Medicare reassignment NPD
• I Ola Lahui Inc

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1194967224
  Medicare reassignment NPD
• Lanai Community Health Center

  • Community/Retail Pharmacy
  • Lanai City, HI
  • NPI 1205413101
  NPD (past)

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1699244509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 NW MONROE AVE STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304708",
            "telephone_number": "541-517-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 NW MONROE AVE STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304708",
            "telephone_number": "541-517-4542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Kapiolani Blvd Ste 1802",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968144408",
            "country_code": "US",
            "telephone_number": "808-525-6255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "JON",
        "middle_name": "JOSEPH",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-20",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1825",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaumyquyen Chung
• Skotti Deanne Church, M.D
• Maria Patricia Ciccarelli
• Christine Cilley
• Phillip Theodore Ciprotti
• Marisela Jessica Cisneros
• City of Corvallis (City of Corvallis - Ambulance)
• Miya Claborn
• Kailey Janet Claggett, LPC
• Krystal Jacinta Clampitt, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.