Individual provider Active NPI

Carol Drucker

  • Clinical Psychologist
  • Albany, CA
National Provider Identifier
1417411372
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY004855 Issued in CA
Practice address
905 Santa Fe Ave
Albany, CA 94706-2119
Phone
(510) 527-1943
NPI assigned
Jan 24, 2019
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY004855 CA Primary

Addresses

Primary practice location

905 Santa Fe Ave
Albany, CA 94706-2119

Mailing address

905 Santa Fe Ave
Albany, CA 94706-2119
Phone (510) 527-1943

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
PSY004855CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1417411372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SANTA FE AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947062119",
            "telephone_number": "510-527-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SANTA FE AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947062119",
            "telephone_number": "510-527-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUCKER",
        "first_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY004855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.