Dr. Justin R. Jaramillo, Psy.D.
Clinical Neuropsychologist in Dallas, TX. Individual provider (NPI-1).
NPI number1699112334
StatusActive
Last updated in NPPESDec 6, 2013
Details
- NPI
- 1699112334
- Entity type
- Individual (NPI-1)
- Name
- Dr. Justin R. Jaramillo
- Credential
- Psy.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2013
- Last updated
- Dec 6, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | – | – | Yes |
| 103TC0700X | Psychologist, Clinical | 071-008545 | IL | |
| 103TR0400X | Psychologist, Rehabilitation | – | – |
Practice location
4500 S Lancaster Rd116a
Dallas, TX 75216-7167
Phone 214-857-1287
Mailing address
4500 S Lancaster Rd # 116aDallas, TX 75216-7167
Phone 214-857-1287
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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