Active NPI
Jamie K Green, PSY.D.
- Clinical Psychologist
- Atascadero, CA
National Provider Identifier
1972857217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25352
- Practice address
- 10333 El Camino Real
Atascadero, CA 93422-5808 - Phone
- (805) 468-2352
- Fax
- (805) 468-3594
- NPI assigned
- Nov 8, 2012
- 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 | 25352 | CA | Primary |
Addresses
Primary practice location
10333 El Camino Real
Atascadero, CA 93422-5808
Mailing address
10333 El Camino Real
Atascadero, CA 93422-5808
Phone (805) 468-2352
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25352 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1972857217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10333 EL CAMINO REAL",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934225808",
"telephone_number": "805-468-2352",
"fax_number": "805-468-3594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10333 EL CAMINO REAL",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934225808",
"telephone_number": "805-468-2352",
"fax_number": "805-468-3594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JAMIE",
"middle_name": "K",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-08",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atascadero, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.