NPIMap

Organization Active NPI

Michelle Ahn MD SC

  • Psychiatry Physician
  • Berkeley, CA
National Provider Identifier
1336665074
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A121280 Issued in CA
Legal business name
MICHELLE AHN MD SC
Practice address
1250 Addison St
Ste 113
Berkeley, CA 94702
Phone
(510) 788-0582
NPI assigned
Aug 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

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

Authorized official

Name
Michelle Ahn, M.D.NPI 1295902930
Title
President
Phone
(510) 788-0582

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A121280 CA Primary

Addresses

Primary practice location

1250 Addison St
Ste 113
Berkeley, CA 94702

Mailing address

1376 Hopkins St
Berkeley, CA 94702

National Provider Directory

National Provider Directory

Locations

1250 Addison St
Ste 113
Berkeley, CA 94702
Phone (510) 788-0582

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502755200000",
    "number": "1336665074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 HOPKINS ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 ADDISON ST",
            "address_2": "STE 113",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702",
            "telephone_number": "510-788-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE AHN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-788-0582",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A121280",
            "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 Aug 15, 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.