Walter Douglas Moorhead, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C35623 Issued in CA

Practice address

2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238

Phone

(510) 981-5290

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 11, 2015 through Dec 11, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• City of Berkeley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1215963699
  NPD (past)
• City of Berkeley

  • Adolescent and Children Mental Health Clinic/Center
  • Berkeley, CA
  • NPI 1750415113
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1447282777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MILVIA ST",
            "address_2": "2RD. FLOOR MH",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041169",
            "telephone_number": "510-981-5221",
            "fax_number": "510-981-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-981-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHEAD",
        "first_name": "WALTER",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C35623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lorraine Fisher Moore, NP, RN
• Koala Bear Moore, L.AC.
• Teresa Mary Moore, MS, NCC
• Heather Chandler Moorhead, MSW
• Kierra Michelle Moorhead
• Lorenzo Mora
• Vanessa Davina Morales, OD
• Sheryl Morasco
• Nadia Luz Moredo, L.AC.
• Traci Vogel Moren, L.AC.

• Psychiatry Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.