Jaseon S. Outlaw, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23676 Issued in CA

Practice address

13847 E 14TH St Ste 202
San Leandro, CA 94578-2626

Phone

(510) 463-1302

NPI assigned

Jul 18, 2012

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 Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Saffron Behavioral Health and Psychology

  • Community/Behavioral Health Agency
  • El Cerrito, CA
  • NPI 1790566263
  Medicare reassignment NPD Authorized official
• Journey of Life Psychological, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Leandro, CA
  • NPI 1073122958
  Medicare reassignment Authorized official
• Journey of Life Counseling and Assessment Services

  • Clinical Psychologist
  • San Leandro, CA
  • NPI 1962824052
  NPD (past) Authorized official

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1861747552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST STE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782626",
            "telephone_number": "510-463-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST STE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782626",
            "telephone_number": "510-463-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "JASEON",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chukwuka Benneth Osuorji, RN
• Brandon Osypiewski, R1580100924
• Joshua Blain Ott
• Fred Ou-Yang, DDS
• Khom Sai J Ounniyom
• Sherrie Xiang Ouyang
• Diahann M Overall
• Jumana Oweis
• Casey Nicholas Owen
• Jacquelyn Owens

• Clinical Psychologist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.