DR. JACQUELINE BUNKER PERSONS
NPI 1447567417
Psychologist - Cognitive & Behavioral in Oakland, CA

Q: What is Jacqueline Persons's NPI number?

The NPI number for Jacqueline Persons is 1447567417. It was assigned to this individual provider in the NPPES registry on September 10, 2010.

Q: What is Jacqueline Persons's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Q: Is Jacqueline Persons enrolled in Medicare?

No. Jacqueline Persons has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since September 10, 2010Opted out of Medicare · through Jan 1, 2028

5435 COLLEGE AVE, SUITE 102, OAKLAND, CA 94618(510) 652-4455(510) 380-2988 Get Directions Write a Review

NPPES record last updated: April 7, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jacqueline Bunker Persons NPPES

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

DR. JACQUELINE BUNKER PERSONS (NPI 1447567417) is an individual cognitive & behavioral provider in Oakland, California, licensed in California (PSY7275) and active in the NPI registry since September 2010. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1447567417

Entity TypeIndividualFemale

Primary Taxonomy103TB0200X

Provider Legal NameDR. JACQUELINE BUNKER PERSONS

Location Address5435 COLLEGE AVE, SUITE 102Oakland, CA 94618-1598

Mailing Address5625 College Ave, Suite 215Oakland, CA 94618-1599 · (510) 992-4040 · Fax (888) 975-9811

Phone(510) 652-4455

Fax(510) 380-2988

Sole ProprietorYes

Enumeration DateSeptember 10, 2010

Last NPPES UpdateApril 7, 2016

✔ NPI 1447567417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers

Taxonomy Code103TB0200X

License✔ Licensed in CA · PSY7275

Definition

A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.

5435 COLLEGE AVE, Oakland, CA 94618

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jacqueline Bunker Persons has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2014 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2014

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEFFREY GILE SHARP PH.D.

Psychologist (Clinical)

5435 COLLEGE AVE, SUITE 202
OAKLAND, CA 94618

Alameda County (510) 653-5233

DR. MICHAEL A. TOMPKINS PH.D.

Psychologist (Clinical)

5435 COLLEGE AVE, SUITE 100-2
OAKLAND, CA 94618

Alameda County (510) 652-4455

MR. ERIC WILLIAM MILL M.A.

Marriage & Family Therapist

5435 COLLEGE AVE, SUITE 202-7
OAKLAND, CA 94618

Alameda County (415) 889-8441

PHYLLIS ANNE MACE M.F.T.

Marriage & Family Therapist

5435 COLLEGE AVE, SUITE 202-5
OAKLAND, CA 94618

Alameda County (510) 704-8455

DR. ALAN ANTHONY VITOLO PH.D.

Psychologist

5435 COLLEGE AVE, SUITE 202-6
OAKLAND, CA 94618

Alameda County (510) 547-7669

LINDA EILEEN KELLER PH.D.

Psychologist (Clinical)

5435 COLLEGE AVE, #201
OAKLAND, CA 94618

Alameda County (510) 654-2420

SHARON STAFANSON PSY.D.

Psychologist

5435 COLLEGE AVE, SUITE 202-6
OAKLAND, CA 94618

Alameda County (510) 219-3029

MR. ROBERT L GORDEN MSW

Social Worker (Clinical)

5435 COLLEGE AVE, SUITE 107
OAKLAND, CA 94618

Alameda County (510) 547-8830

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 Jacqueline Persons's NPI number?

The NPI number for Jacqueline Persons is 1447567417. It was assigned to this individual provider in the NPPES registry on September 10, 2010.

Where is Jacqueline Persons located?

Jacqueline Persons practices at 5435 College Ave Suite 102, Oakland, CA 94618. The listed phone number is (510) 652-4455.

What is Jacqueline Persons's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Jacqueline Persons enrolled in Medicare?

No. Jacqueline Persons has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jacqueline Persons was last updated on April 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.