Holly Lynn Buckman, MS CLINICAL PSYCHOLO

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

Practice address

1440 Broadway Ste 314
Oakland, CA 94612-2023

Phone

(888) 524-5122

Fax

(888) 524-5122

NPI assigned

May 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Psychological Assessment, Inc.

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1215310354
  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1205363199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 HIGDON AVE APT 3",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940411027",
            "telephone_number": "219-252-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 BROADWAY STE 314",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122023",
            "telephone_number": "888-524-5122",
            "fax_number": "888-524-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMAN",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "credential": "MS CLINICAL PSYCHOLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Killian Buck, RBT
• Sara Buckelew, MD
• Annadine Buckingham
• Kelsi Buckley, RD, MS, CSOWM
• Theresa N Buckley
• Mike Buckman
• Michquinell Buckner
• Nancy J. Buell, LCSW
• Alma Sharise Buenavista, MSW,PPSC,ASW
• Joana Ruby Callanta Bueno, PMHNP-BC

• Forensic Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; 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.