<unavail> in El Cerrito, CA - Medicare Community/Behavioral Health

is a medicare enrolled mental health clinic (Community/behavioral Health) in El Cerrito, California. The current practice location for is 406 Colusa Ave, El Cerrito, California. For appointments, you can reach them via phone at (510) 913-2232. The mailing address for is 406 Colusa Ave, El Cerrito, California and phone number is () -.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1790566263. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (510) 913-2232.

Contact Information


	406 Colusa Ave El Cerrito CA 94530-3327
	(510) 913-2232
	Not Available

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Community/Behavioral Health
Location	406 Colusa Ave, El Cerrito, California
Authorized Official Name and Position	Jaseon Outlaw (CEO)
Authorized Official Contact	5105645955
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
406 Colusa Ave El Cerrito CA 94530-3327 Ph: () -	406 Colusa Ave El Cerrito CA 94530-3327 Ph: (510) 913-2232

NPI Details:

NPI Number	1790566263
Provider Enumeration Date	10/11/2023
Last Update Date	03/31/2024
Certification Date	03/31/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	7517306871
Medicare Enrollment ID	O20240418003817

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790566263	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC1900X	Psychologist - Counseling	(* (Not Available))	Secondary
251S00000X	Community/behavioral Health	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Jaseon Outlaw
Provider Type	Practitioner - Clinical Psychologist
Provider Identifiers	NPI Number: 1861747552 PECOS PAC ID: 0749560449 Enrollment ID: I20161215002226

Reviews and Comments

Community/Behavioral Health in El Cerrito, CA

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- Medicare Mental Health Clinic in El Cerrito, CA