Individual provider Active NPI

Adrienne Faye Berlin, LCSW

  • Clinical Social Worker
  • La Jolla, CA
National Provider Identifier
1164560744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS13852 Issued in CA
Practice address
7946 Ivanhoe Ave
Suite Number 205
La Jolla, CA 92037-4516
Phone
(619) 251-3877
Fax
(858) 790-3745
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS13852 CA Primary

Addresses

Primary practice location

7946 Ivanhoe Ave
Suite Number 205
La Jolla, CA 92037-4516

Mailing address

6626 Tyrian St
La Jolla, CA 92037-6150
Phone (619) 251-3877

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

State licenses

LicenseStateTypeSpecialty
LCS13852CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164560744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 TYRIAN ST",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376150",
            "telephone_number": "619-251-3877",
            "fax_number": "858-790-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7946 IVANHOE AVE",
            "address_2": "SUITE NUMBER 205",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374516",
            "telephone_number": "619-251-3877",
            "fax_number": "858-790-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "ADRIENNE",
        "middle_name": "FAYE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.