Provider Demographics
NPI:1528257904
Name:NEAKRASE, JASON EDWARD (PSYD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:EDWARD
Last Name:NEAKRASE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CALIFORNIA DR.
Mailing Address - Street 2:1600 CALIFORNIA DR.
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7682
Mailing Address - Country:US
Mailing Address - Phone:707-317-4214
Mailing Address - Fax:
Practice Address - Street 1:1600 CALIFORNIA DR.
Practice Address - Street 2:1600 CALIFORNIA DR.
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7682
Practice Address - Country:US
Practice Address - Phone:707-317-4214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23121103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical