Jackson Doyle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101326 Issued in CA

Practice address

35 W Main St Ste B346
Ventura, CA 93001-4500

Phone

(805) 794-0010

NPI assigned

Jun 14, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment Care Compare group NPD
• Alameda Health System

  • Clinic/Center
  • Alameda, CA
  • NPI 1124446158
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1770151003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W MAIN ST STE B346",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930014500",
            "telephone_number": "805-794-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W MAIN ST STE B346",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930014500",
            "telephone_number": "805-794-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St # K6",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-437-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "JACKSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Rose Doud, DPT
• Erika Ann Dowd
• John J. Dowling III, LMFT
• Brandon Downs
• Alan Doyle, LCSW
• Dr Anna Selena Cho Child and Family Therapist Inc
• Dr Brad Barrows Inc
• Dr Funnell Optometry Inc
• Dr. Carey B. Poultney, O.D., a Professional Optometric Corporation
• Dr. Elena B Dental Corporation

• Clinical Social Worker in Ventura, CA
• Providers in Ventura, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.