Active NPI
Jessica Buckland, PSY. D.
- Clinical Psychologist
- State College, PA
National Provider Identifier
1952721912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017577
- Practice address
- 320 Rolling Ridge Dr
State College, PA 16801-7641 - Phone
- (814) 867-0670
- NPI assigned
- Apr 17, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS017577 | PA | Primary |
Addresses
Primary practice location
320 Rolling Ridge Dr
State College, PA 16801-7641
Mailing address
320 Rolling Ridge Dr
State College, PA 16801-7641
Phone (814) 867-0670
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS017577 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1952721912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 ROLLING RIDGE DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017641",
"telephone_number": "814-867-0670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 ROLLING RIDGE DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017641",
"telephone_number": "814-867-0670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLAND",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PSY. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-17",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.