Active NPI
Jessie James King Jr.
- Counselor
- Oakland, CA
National Provider Identifier
1720508039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 9925 International Blvd Suite #5
9925 International Blvd Suite #5
Oakland, CA 94603 - Phone
- 15107771177
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
9925 International Blvd Suite #5
9925 International Blvd Suite #5
Oakland, CA 94603
Mailing address
9925 International Blvd Ste 59925
Oakland, CA 94603-2558
Phone (510) 777-1177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D1871094 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1720508039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9925 INTERNATIONAL BLVD STE 59925",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946032558",
"telephone_number": "15107771177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9925 INTERNATIONAL BLVD SUITE #5",
"address_2": "9925 INTERNATIONAL BLVD SUITE #5",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94603",
"telephone_number": "15107771177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JESSIE",
"middle_name": "JAMES",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D1871094",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.