NPIMap

Organization Active NPI

Jacqueline a Rondeau PSYD

  • Clinical Neuropsychologist
  • Montclair, NJ
National Provider Identifier
1992182372
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00390000 Issued in NJ
Legal business name
JACQUELINE A RONDEAU PSYD
Practice address
70 Park St
Suite 207
Montclair, NJ 07042-5907
Phone
(973) 743-4555
Fax
(973) 743-4055
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Dr. Jacqueline Ann Rondeau, PSYDNPI 1285622217
Title
Clinical Director
Phone
(973) 743-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 35SI00390000 NJ Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 35SI00390000 NJ

Addresses

Primary practice location

70 Park St
Suite 207
Montclair, NJ 07042-5907

Mailing address

375 Belleville Ave
Bloomfield, NJ 07003-2634
Phone (973) 743-4555

Other identifiers 1

IdentifierTypeStateIssuer
0051560MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Jacqueline a Rondeau PSYD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1992182372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BELLEVILLE AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032634",
            "telephone_number": "973-743-4555",
            "fax_number": "973-743-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PARK ST",
            "address_2": "SUITE 207",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070425907",
            "telephone_number": "973-743-4555",
            "fax_number": "973-743-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE A RONDEAU PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "RONDEAU",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-743-4555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00390000",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00390000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051560",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.