Jacob Andrew Eide, PSY.D.

Individual provider Active NPI Clinical Psychologist · Mammoth Lakes, CA

NPI 1760701023 · NPPES record last updated Jan 27, 2026

Key facts

NPI
1760701023
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY27059 (CA)
Practice address
85 Sierra Park Rd
Mammoth Lakes, CA 93546
Phone
(760) 924-4333
NPI assigned
May 26, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Mono Health Care District (94 clinicians)

Practice addresses (Care Compare)

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073
Phone (760) 934-3311

PO Box
Suite 660
Mammoth Lakes, CA 93546-0660

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 IDStateProvider typePAC IDDetails
I20180201003192 CA Practitioner - Clinical Psychologist 1850417171 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PSY27059CAMDClinical Psychologist
27059CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Mono Health Care District Current
since Dec 22, 2017
Accepting new patients
Action Potential Psychological Services, Inc. Clinical Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mahojeide@mammothhospital.cernerdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY27059 CA Yes

Addresses

Primary practice location

85 Sierra Park Rd
Mammoth Lakes, CA 93546

Mailing address

858 S Barlow LN
Bishop, CA 93514-3144
Phone (206) 407-7930

Other practice location 1

858 S Barlow Ln
Bishop, CA 93514-3144
Phone (206) 407-7930

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address Mahojeide@mammothhospital.cernerdirect.com Direct

Other providers in Mammoth Lakes, CA

All providers in Mammoth Lakes, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.