Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jaseon S. Outlaw, PHD

Individual provider Clinical Psychologist · NPI 1861747552

Dr. Jaseon S. Outlaw, PHD is a Clinical Psychologist in San Leandro, California. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2012
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

13847 E 14th St Ste 202
San Leandro, CA 94578-2626
Phone: (510) 463-1302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY23676 (CA)

Record details

NPI number1861747552
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJuly 18, 2012
Last updated in NPPESMarch 29, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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