Active NPI
Jason Daniel Camacho, MS, PPS
- School Psychologist
- San Rafael, CA
National Provider Identifier
1851207211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 177 N San Pedro Rd
San Rafael, CA 94903-4200 - Phone
- (415) 492-3150
- NPI assigned
- Aug 24, 2026
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
177 N San Pedro Rd
San Rafael, CA 94903-4200
Mailing address
2775 11TH St
San Pablo, CA 94806-2267
Phone (562) 396-7802
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1851207211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2775 11TH ST",
"city": "SAN PABLO",
"state": "CA",
"postal_code": "948062267",
"telephone_number": "562-396-7802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 N SAN PEDRO RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949034200",
"telephone_number": "415-492-3150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "JASON",
"middle_name": "DANIEL",
"credential": "MS, PPS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.