Jayne D Hagen

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

JAYNE D HAGEN

Practice address

1213 Masonic Ave
Berkeley, CA 94706-2329

Phone

(510) 778-4055

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Jayne D. Hagen, PHDNPI 1104087071

Title

Owner

Phone

(510) 778-4055

Specialties & licenses 2

Addresses

Other names 1

• Neurobehavioral Health Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jayne D. Hagen, PH.D

  • Clinical Neuropsychologist
  • Berkeley, CA
  • NPI 1104087071
  NPD Authorized official

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1770122178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 MASONIC AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062329",
            "telephone_number": "510-778-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 MASONIC AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062329",
            "telephone_number": "510-778-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYNE D HAGEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-778-4055",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurobehavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neda Javadi
• Shahin M Javaheri, MD
• Yasmin Faridun Javed, OD
• Alanna Javier
• Sarah Jay
• Claire Jeannette, MFT LICENSE
• Daniel Jedynak
• Genean Jeffery-Johnson, MA
• Jeffrey L. Stern, M.D., Apc
• Lynn Jehle, NP

• Clinical Neuropsychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.