Individual provider Active NPI

Catherine Ann Mitsuko Berner

  • Psychologist
  • Berkeley, CA
National Provider Identifier
1295384048
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
94027910 Issued in CA
Practice address
3075 Adeline St Ste 120
Berkeley, CA 94703-2579
Phone
(510) 848-1112
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 94027910 CA Primary

Addresses

Primary practice location

3075 Adeline St Ste 120
Berkeley, CA 94703-2579

Mailing address

104 Jetty Dr
Richmond, CA 94804-4233
Phone (510) 701-8527

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

LicenseStateTypeSpecialty
94027910CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Through the Looking Glass CurrentSince Dec 10, 2023 Accepting new patients

Locations

3075 Adeline St
Ste 120
Berkeley, CA 94703
Phone (510) 225-7572

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.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1295384048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 JETTY DR",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948044233",
            "telephone_number": "510-701-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 ADELINE ST STE 120",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032579",
            "telephone_number": "510-848-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNER",
        "first_name": "CATHERINE",
        "middle_name": "ANN MITSUKO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "94027910",
            "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 Sep 9, 2024; 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.