Healthcare Provider Details

I. General information

NPI: 1235786500
Provider Name (Legal Business Name): JASHNEEL J SINGH PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 ESTUDILLO AVE STE D
SAN LEANDRO CA
94577-4923
US

IV. Provider business mailing address

444 ESTUDILLO AVE STE D
SAN LEANDRO CA
94577-4923
US

V. Phone/Fax

Practice location:
  • Phone: 510-470-4964
  • Fax: 510-470-5969
Mailing address:
  • Phone: 510-470-4964
  • Fax: 510-470-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: