Organization Active NPI

Antonia Bercovici, PH.D. Inc.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1033472824
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
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, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
GB074AOtherCAMEDICARE PTAN
1184765935OtherCATYPE 1 NPI

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.