Active NPI
Michele Stacy Berk, PHD
- Clinical Psychologist
- Palo Alto, CA
National Provider Identifier
1457386278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY19929
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8000
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY19929 | CA | Primary |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY199290 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY19929 | CA | MD | Clinical Psychologist |
| 19929 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1457386278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERK",
"first_name": "MICHELE",
"middle_name": "STACY",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY19929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY199290",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.