Active NPI
Hannah Gail Bosley, PHD
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1023733565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 33633
- 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
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 | 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33633 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkeley Therapy Institute | Clinical | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.