Active NPI
Andrea Berendsen, PSYD
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1477924330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY29840
- Practice address
- 1516 Edith St
Berkeley, CA 94703-1124 - Phone
- (925) 518-8473
- NPI assigned
- Oct 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | PSY29840 | CA | Primary |
Addresses
Primary practice location
1516 Edith St
Berkeley, CA 94703-1124
Mailing address
1516 Edith St
Berkeley, CA 94703-1124
Phone (925) 518-8473
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29840 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1477924330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 EDITH ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031124",
"telephone_number": "925-518-8473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 EDITH ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031124",
"telephone_number": "925-518-8473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERENDSEN",
"first_name": "ANDREA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-16",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY29840",
"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 Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.