Active NPI
David F Berke, PH.D.
- Clinical Psychologist
- San Mateo, CA
National Provider Identifier
1013265156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY6573
- Practice address
- 177 Bovet Rd
San Mateo, CA 94402-3116 - Phone
- (650) 343-9993
- NPI assigned
- Aug 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY6573 | CA | Primary |
Addresses
Primary practice location
177 Bovet Rd
San Mateo, CA 94402-3116
Mailing address
156 Pepper Ave
Burlingame, CA 94010-5248
Phone (650) 678-5692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6573 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1013265156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 PEPPER AVE",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940105248",
"telephone_number": "650-678-5692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 BOVET RD",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023116",
"telephone_number": "650-343-9993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERKE",
"first_name": "DAVID",
"middle_name": "F",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-21",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY6573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.