Individual provider Active NPI

Salvador Tinoco Jaramillo

  • School Psychologist
  • Fremont, CA
National Provider Identifier
1942739305
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
230131245 Issued in CA
Practice address
41800 Blacow Rd
Fremont, CA 94538-3353
Phone
(510) 656-5711
NPI assigned
Jun 8, 2017
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 230131245 CA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

41800 Blacow Rd
Fremont, CA 94538-3353

Mailing address

41800 Blacow Rd
Fremont, CA 94538-3353
Phone (510) 656-5711

Other identifiers 1

IdentifierTypeStateIssuer
XXXXXXMedicaidCA

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

State licenses

LicenseStateTypeSpecialty
230131245CAMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Fremont CurrentSince Feb 23, 2025 Accepting new patients

Locations

41800 Blacow Rd
Fremont, CA 94538
Phone (510) 656-5711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1942739305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 BLACOW RD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945383353",
            "telephone_number": "510-656-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 BLACOW RD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945383353",
            "telephone_number": "510-656-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINOCO JARAMILLO",
        "first_name": "SALVADOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "230131245",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XXXXXX",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.