Individual provider Active NPI

Hannah Gail Bosley, PHD

  • Clinical Psychologist
  • Berkeley, CA
National Provider Identifier
1023733565
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33633 Issued in CA
Practice address
1749 Martin Luther King Jr Way
Berkeley, CA 94709-2139
Phone
(903) 780-4316
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 33633 CA Primary

Addresses

Primary practice location

1749 Martin Luther King Jr Way
Berkeley, CA 94709-2139

Mailing address

1749 Martin Luther King Jr Way
Berkeley, CA 94709-2139
Phone (903) 780-4316

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
I20230217001006 CA Practitioner - Clinical Psychologist 0941672067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Berkeley Therapy InstituteGroup PAC ID 2264414283, 13 clinicians

Practice addresses (Care Compare)

1749 Martin Luther King Jr Way
Berkeley, CA 94709-2139
Phone 51084184841130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33633CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Therapy Institute Clinical CurrentSince Feb 9, 2023 Accepting new patients

Locations

1749 Martin Luther King Jr Way
Berkeley, CA 94709
Phone (510) 540-1746

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1023733565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947092139",
            "telephone_number": "903-780-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947092139",
            "telephone_number": "903-780-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "HANNAH",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.