NPIMap

Organization Active NPI

Clearwater Psychological Services

Doing business as Clearwater Counseling and Assessment Services

  • Psychologist
  • Oakland, CA
National Provider Identifier
1083810527
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 16276 Issued in CA
Legal business name
CLEARWATER PSYCHOLOGICAL SERVICES
Doing business as
Clearwater Counseling and Assessment Services
Practice address
345 38TH St
Oakland, CA 94609-2703
Phone
(510) 596-8137
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sharon Witkin, PH.D.
Title
Executive Director
Phone
(510) 596-8137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY 16276 CA Primary

Addresses

Primary practice location

345 38TH St
Oakland, CA 94609-2703

Mailing address

345 38TH St
Oakland, CA 94609-2703
Phone (510) 596-8137

Other names 1

  • Clearwater Counseling and Assessment Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clearwater Counseling and Assessment Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083810527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 38TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092703",
            "telephone_number": "510-596-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 38TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092703",
            "telephone_number": "510-596-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WITKIN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "510-596-8137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 16276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Counseling and Assessment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.