Active NPI
Samuel Himelstein, PH.D.
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1265749790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25229
- Practice address
- 4400 Keller Ave Ste 200
Oakland, CA 94605-4229 - Phone
- (510) 295-8977
- NPI assigned
- Sep 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | PSY25229 | CA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY25229 | CA | |
| Clinical Psychologist | 103TC0700X | PSY25229 | CA | Primary |
| Group Psychotherapy Psychologist | 103TP2701X | PSY25229 | CA |
Addresses
Primary practice location
4400 Keller Ave Ste 200
Oakland, CA 94605-4229
Mailing address
4400 Keller Ave Ste 200
Oakland, CA 94605-4229
Phone (510) 470-5777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25229 | CA | MD | Group Psychotherapy Psychologist |
| 25229 | CA | MD | General Practice Dentistry |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Berkeley, CA
- NPI 1699327692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562976000000",
"number": "1265749790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 KELLER AVE STE 200",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946054229",
"telephone_number": "510-470-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 KELLER AVE STE 200",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946054229",
"telephone_number": "510-295-8977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMELSTEIN",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-03",
"last_updated": "2019-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "PSY25229",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY25229",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25229",
"primary": true
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "CA",
"license": "PSY25229",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.