Individual provider Active NPI

Barbara Vivino, PHD

  • Clinical Psychologist
  • Berkeley, CA
National Provider Identifier
1023239696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY17102 Issued in CA
Practice address
921 The Alameda
Berkeley, CA 94707
Phone
(510) 428-9096
Fax
(510) 280-7263
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY17102 CA Primary

Addresses

Primary practice location

921 The Alameda
Berkeley, CA 94707

Mailing address

921 The Alameda
Berkeley, CA 94707
Phone (510) 428-9096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000488 CA Practitioner - Clinical Psychologist 8527243310 Practice locations: Berkeley, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

921 The Alamda
Suite 109
Berkeley, CA 94707-2311
Phone (510) 428-9096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY17102CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023239696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 THE ALAMEDA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94707",
            "telephone_number": "510-428-9096",
            "fax_number": "510-280-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 THE ALAMEDA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94707",
            "telephone_number": "510-428-9096",
            "fax_number": "510-280-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVINO",
        "first_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.