Individual provider Active NPI

Gail Shafarman, PHD

  • Psychologist
  • Berkeley, CA
National Provider Identifier
1407863830
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 14633 Issued in CA
Practice address
1947 Francisco St
Berkeley, CA 94709-2123
Phone
(510) 655-5582
Fax
(510) 655-6129
NPI assigned
Aug 1, 2006
Last updated
Nov 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 14633 CA Primary

Addresses

Primary practice location

1947 Francisco St
Berkeley, CA 94709-2123

Mailing address

6011 Hillegass Ave
Oakland, CA 94618-1234
Phone (510) 655-5582

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000907 CA Practitioner - Clinical Psychologist 4981737723 Practice locations: Berkeley, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1947 Francisco St
Berkeley, CA 94709-2123
Phone (510) 655-5582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 14633CAMDPsychologist
14633CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1407863830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 HILLEGASS AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181234",
            "telephone_number": "510-655-5582",
            "fax_number": "510-655-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 FRANCISCO ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947092123",
            "telephone_number": "510-655-5582",
            "fax_number": "510-655-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFARMAN",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 14633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.