Active NPI
Jay J. Joseph, PSY.D.
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1871657205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18905
- Practice address
- 5665 College Ave
Suite 220C
Oakland, CA 94618-1625 - Phone
- (510) 295-5490
- Fax
- (510) 540-6346
- NPI assigned
- Dec 20, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18905 | CA | Primary |
Addresses
Primary practice location
5665 College Ave
Suite 220C
Oakland, CA 94618-1625
Mailing address
PO Box 5653
Berkeley, CA 94705-0653
Phone (510) 295-5490
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091205000069 | CA | Practitioner - Clinical Psychologist | 7618016551 | Practice locations: Oakland, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5845 College Ave
Suite 7
Oakland, CA 94618-1635
Phone (510) 295-5490
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18905 | CA | MD | Professional Counselor |
| PSY18905 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871657205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5653",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947050653",
"telephone_number": "510-295-5490",
"fax_number": "510-540-6346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 COLLEGE AVE",
"address_2": "SUITE 220C",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946181625",
"telephone_number": "510-295-5490",
"fax_number": "510-540-6346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "JAY",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.