Dr Jaseon S Outlaw, PHD in San Leandro, CA - Medicare Psychologist Provider

Dr Jaseon S Outlaw, PHD is a medicare enrolled "Psychologist - Clinical" provider in San Leandro, California. His current practice location is 13847 E 14th St Ste 202, San Leandro, California. You can reach out to his office (for appointments etc.) via phone at (510) 463-1302.

Dr Jaseon S Outlaw is licensed to practice in California (license number PSY23676) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861747552.

Contact Information

	Dr Jaseon S Outlaw, PHD
	13847 E 14th St Ste 202, San Leandro, CA 94578-2626
	(510) 463-1302
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jaseon S Outlaw
Gender	Male
Speciality	Psychologist - Clinical
Location	13847 E 14th St Ste 202, San Leandro, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861747552
Provider Enumeration Date: 07/18/2012
Last Update Date: 03/29/2016

Medicare PECOS Information:

PECOS PAC ID: 0749560449
Enrollment ID: I20161215002226

Medical Identifiers

Medical identifiers for Dr Jaseon S Outlaw such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861747552	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY23676 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jaseon S Outlaw allows following entities to bill medicare on his behalf.

Entity Name	Journey Of Life Psychological Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073122958 PECOS PAC ID: 7214339423 Enrollment ID: O20210712000326

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jaseon S Outlaw is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jaseon S Outlaw, PHD 13847 E 14th St Ste 202, San Leandro, CA 94578-2626 Ph: (510) 463-1302	Dr Jaseon S Outlaw, PHD 13847 E 14th St Ste 202, San Leandro, CA 94578-2626 Ph: (510) 463-1302

Reviews and Comments

Psychologist in San Leandro, CA

Devonna Jacobs, Psychologist Medicare: Medicare Enrolled Practice Location: 3081 Teagarden St, San Leandro, CA 94577 Phone: 510-347-4620
Ms. Brittany Schnebly, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3081 Teagarden St, San Leandro, CA 94577 Phone: 510-347-4620
Dr. James W. Kurkjian, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 13851 E 14th St, Ste. 203, San Leandro, CA 94578 Phone: 510-351-4311
Erica Wandner, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 13666 East 14th St, San Leandro, CA 94578 Phone: 510-357-5515 Fax: 510-357-5112
Dr. Janice Thomas, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2500 Fairmont Dr, San Leandro, CA 94578 Phone: 510-667-3009 Fax: 510-667-3005
Dr. Kimberly A Bradley, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2275 Arlington Dr, San Leandro, CA 94578 Phone: 510-317-1444
Gregory Richard Larson, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 333 Estudillo Ave, #207, San Leandro, CA 94577 Phone: 510-541-2983

Dr Jaseon S Outlaw, PHD - Medicare Psychologist in San Leandro, CA