Active NPI
Diana Jean Gleason, PSY.D.
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1205854874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18254
- Practice address
- 1525 Shattuck Ave Ste B
Berkeley, CA 94709 - Phone
- (510) 433-7273
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18254 | CA | Primary |
Addresses
Primary practice location
1525 Shattuck Ave Ste B
Berkeley, CA 94709
Mailing address
1525 Shattuck Ave Ste B
Berkeley, CA 94709-1500
Phone (510) 433-7273
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18254 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY18254 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1205854874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 SHATTUCK AVE STE B",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947091500",
"telephone_number": "510-433-7273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 SHATTUCK AVE STE B",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94709",
"telephone_number": "510-433-7273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLEASON",
"first_name": "DIANA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18254",
"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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.