Connor J Tindall, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY34653 Issued in CA

Practice address

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

Phone

(510) 768-8181

NPI assigned

Jul 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Berkeley Therapy Institute

  • Psychiatry Physician
  • Berkeley, CA
  • NPI 1255497814
  Medicare reassignment NPD
• Hyde Street Community Services, Inc

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1033278940
  NPD (past)

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1033697156",
    "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": "510-768-8181"
        },
        {
            "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": "510-768-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "CONNOR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY34653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Tiffin
• Bertha Jeanean Tillison-Mejia
• Aqueelah Tillman, CNM
• Timothy a Fitzer MD Inc a Professional Medical Corporation (Berkeley Family Practice Medical Group)
• Marilyn Tims
• Debora W Tingley, PHD, MS
• Linda Marie Titus-Conboy, MSW
• Jessica Elizabeth Tkachuk, DPT
• Angelica To
• Meridel Pearl Tobias, LMFT

• Psychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.