Individual provider Active NPI

Heather Marie Berberet, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1194863357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16920 Issued in CA
Practice address
3101 4TH Ave
San Diego, CA 92103-5802
Phone
(619) 379-8513
NPI assigned
Feb 1, 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 Psychologist 103TC0700X PSY16920 CA Primary

Addresses

Primary practice location

3101 4TH Ave
San Diego, CA 92103-5802

Mailing address

3101 4TH Ave
San Diego, CA 92103-5802
Phone (619) 379-8513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY16920CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194863357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035802",
            "telephone_number": "619-379-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035802",
            "telephone_number": "619-379-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERET",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.