Active NPI
Randi D. Jackson, PHD
- Psychologist
- San Francisco, CA
National Provider Identifier
1942080056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 2211 Post St Ste 300
San Francisco, CA 94115-3442 - Phone
- (415) 859-1616
- NPI assigned
- Oct 5, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
2211 Post St Ste 300
San Francisco, CA 94115-3442
Mailing address
6556 Bridgewood Dr
Santa Rosa, CA 95409-2610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1942080056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6556 BRIDGEWOOD DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954092610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 POST ST STE 300",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941153442",
"telephone_number": "415-859-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RANDI",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.