Active NPI
Sherrika Green, PSY.D.
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1265815971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32511
- Practice address
- 2283 International Blvd Apt 208
Oakland, CA 94606-5043 - Phone
- (510) 866-3091
- NPI assigned
- Jun 30, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 32511 | CA | Primary |
Addresses
Primary practice location
2283 International Blvd Apt 208
Oakland, CA 94606-5043
Mailing address
2283 International Blvd Apt 208
Oakland, CA 94606-5043
Phone (510) 866-3091
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811185259 | Medicaid | CA | |
| 1689863516 | Medicaid | CA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32511 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645660800000",
"number": "1265815971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2283 INTERNATIONAL BLVD APT 208",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946065043",
"telephone_number": "510-866-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2283 INTERNATIONAL BLVD APT 208",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946065043",
"telephone_number": "510-866-3091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "SHERRIKA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-30",
"last_updated": "2022-02-24",
"certification_date": "2022-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811185259",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689863516",
"state": "CA"
}
],
"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 Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.