Active NPI
Matthew P White, MD
- Psychiatry Physician
- Berkeley, CA
National Provider Identifier
1083805378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A71577
- Practice address
- 2633 Marin Ave
Berkeley, CA 94708-1527 - Phone
- (510) 559-8469
- Fax
- (650) 724-3144
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A71577 | CA | Primary |
Addresses
Primary practice location
2633 Marin Ave
Berkeley, CA 94708-1527
Mailing address
2633 Marin Ave
Berkeley, CA 94708-1527
Phone (510) 559-8469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A71577 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avant Inpatient Services Medical Group, Inc | Past | Accepting new patients |
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.
-
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- Castro Valley, CA
- NPI 1336106897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1083805378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2633 MARIN AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947081527",
"telephone_number": "510-559-8469",
"fax_number": "650-724-3144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 MARIN AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947081527",
"telephone_number": "510-559-8469",
"fax_number": "650-724-3144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "MATTHEW",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A71577",
"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 Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.