Active NPI
Antonia Bercovici, PH.D. Inc.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1033472824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- ANTONIA BERCOVICI, PH.D. INC.
- Practice address
- 450 Sutter St
Suite 2116
San Francisco, CA 94108-4206 - Phone
- (415) 395-9299
- Fax
- (510) 647-9452
- NPI assigned
- Jun 18, 2012
- Last updated
- Jun 18, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Antonia Bercovici
- Title
- President
- Phone
- (415) 395-9299
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | ||
| Professional Counselor | 101YP2500X | NU | ||
| Clinical Neuropsychologist | 103G00000X | NU | ||
| Adult Development & Aging Psychologist | 103TA0700X | NU | ||
| Clinical Psychologist | 103TC0700X | NU | Primary | |
| Counseling Psychologist | 103TC1900X | NU | ||
| Clinical Child & Adolescent Psychologist | 103TC2200X | NU | ||
| Family Psychologist | 103TF0000X | NU | ||
| Marriage & Family Therapist | 106H00000X | NU | ||
| Behavior Analyst | 103K00000X | NU | ||
| Psychoanalyst | 102L00000X | NU |
Addresses
Primary practice location
450 Sutter St
Suite 2116
San Francisco, CA 94108-4206
Mailing address
450 Sutter St
Suite 2116
San Francisco, CA 94108-4206
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GB074A | Other | CA | MEDICARE PTAN |
| 1184765935 | Other | CA | TYPE 1 NPI |
National Provider Directory
National Provider DirectoryLocations
450 Sutter St
Rm 2116
San Francisco, CA 94108
Phone (415) 395-0299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339977600000",
"number": "1033472824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 SUTTER ST",
"address_2": "SUITE 2116",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941084206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SUTTER ST",
"address_2": "SUITE 2116",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941084206",
"telephone_number": "415-395-9299",
"fax_number": "510-647-9452"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANTONIA BERCOVICI, PH.D. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-18",
"last_updated": "2012-06-18",
"status": "A",
"authorized_official_last_name": "BERCOVICI",
"authorized_official_first_name": "ANTONIA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "415-395-9299"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "GB074A",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TYPE 1 NPI",
"identifier": "1184765935",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.