Individual provider · Type 1 NPI

Jamie Southerland

Rehabilitation Practitioner · San Leandro, CA

NPI number 1629784236 Active

Practice location

777 Davis St
San Leandro, CA 94577-6923

Call (414) 656-0116 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Mental Health Counselor 101YM0800XNone listed
Community Health Worker 172V00000XNone listed
Rehabilitation Practitioner Primary 225400000XNone listed

Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

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About NPI 1629784236

Jamie Southerland's National Provider Identifier is 1629784236, issued on Jan 26, 2023. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in San Leandro, CA. The record was last updated on Sep 2, 2025.