DR. JASEON S. OUTLAW PHD
NPI 1861747552
Psychologist - Clinical in San Leandro, CA
About Dr. Jaseon S. Outlaw Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JASEON S. OUTLAW PHD (NPI 1861747552) is an individual clinical provider in San Leandro, California, licensed in California (PSY23676) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jaseon S. Outlaw Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jaseon Outlaw reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Leandro, CA 94578
- Reassigned Medicare billing, California enrollment
El Cerrito, CA 94530
- Reassigned Medicare billing, California enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94578 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN LEANDRO, CA 94578
SAN LEANDRO, CA 94578
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 Jaseon Outlaw's NPI number?
The NPI number for Jaseon Outlaw is 1861747552. It was assigned to this individual provider in the NPPES registry on July 18, 2012.
Where is Jaseon Outlaw located?
Jaseon Outlaw practices at 13847 E 14th St Ste 202, San Leandro, CA 94578. The listed phone number is (510) 463-1302.
What is Jaseon Outlaw's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jaseon Outlaw enrolled in Medicare?
Yes. Jaseon Outlaw is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jaseon Outlaw's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaseon Outlaw reassigns Medicare benefits to 2 organizations: Journey Of Life Psychological, Inc. (San Leandro, CA) and Saffron Behavioral Health And Psychology (El Cerrito, CA). Each 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 Jaseon Outlaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jaseon Outlaw was last updated on March 29, 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.
# Dr. Jaseon S. Outlaw, PHD · NPI 1861747552
Clinical provider in San Leandro, California. Individual provider, active in the CMS NPPES registry since July 18, 2012.
## Identity
- **NPI:** 1861747552 (Entity type: Individual)
- **Enumerated:** July 18, 2012
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY23676 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 13847 E 14TH ST STE 202, San Leandro, CA 94578-2626
- **Phone:** (510) 463-1302
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Journey Of Life Psychological, Inc. (NPI 1073122958, San Leandro, CA); Saffron Behavioral Health And Psychology (NPI 1790566263, El Cerrito, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** March 29, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1861747552) · Data from the CMS NPPES public registry.