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JOURNEY OF LIFE PSYCHOLOGICAL, INC.
NPI 1073122958
Clinic/Center - Mental Health (Including Community Mental Health Center) in San Leandro, CA

Active since July 28, 2020
13847 E 14TH ST STE 202, SAN LEANDRO, CA 94578(510) 564-5955(510) 817-4112 Get Directions Write a Review

NPPES record last updated: July 28, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Journey Of Life Psychological, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOURNEY OF LIFE PSYCHOLOGICAL, INC. (NPI 1073122958) is a healthcare organization registered as a mental health (including community mental health center) in San Leandro, California and active in the NPI registry since July 2020. The organization lists Jaseon Outlaw, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073122958
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameJOURNEY OF LIFE PSYCHOLOGICAL, INC.
Location Address13847 E 14TH ST STE 202San Leandro, CA 94578-2626
Mailing Address13847 E 14th St Ste 202San Leandro, CA 94578-2626 · (510) 564-5955 · Fax (510) 817-4112
Phone(510) 564-5955
Fax(510) 817-4112
Organization SubpartNo
Authorized OfficialJaseon OutlawCeo · (510) 463-1302
Enumeration DateJuly 28, 2020
NPPES CertifiedJuly 28, 2020
✔ NPI 1073122958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
13847 E 14TH ST STE 202, San Leandro, CA 94578
Open in Google Maps ↗

Other Identifiers 1

MedicaidCA228465CA

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Journey Of Life Psychological, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Journey Of Life Psychological, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Jaseon Outlaw, PHD
Clinical Psychologist
NPI 1861747552
13847 E 14TH ST STE 202
San Leandro, CA 94578
(510) 463-1302
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Journey Of Life Psychological, Inc.'s NPI number?

The NPI number for Journey Of Life Psychological, Inc. is 1073122958. It was assigned to this organization in the NPPES registry on July 28, 2020.

Where is Journey Of Life Psychological, Inc. located?

Journey Of Life Psychological, Inc. is located at 13847 E 14th St Ste 202, San Leandro, CA 94578. The listed phone number is (510) 564-5955.

What is Journey Of Life Psychological, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Journey Of Life Psychological, Inc. enrolled in Medicare?

Yes. Journey Of Life Psychological, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Journey Of Life Psychological, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Journey Of Life Psychological, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Journey Of Life Psychological, Inc. was last updated on July 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.