Active NPI
Caroline Vetter, PSYD
- Psychologist
- Berkeley, CA
National Provider Identifier
1477925253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 32615
- Practice address
- 2375 Shattuck Ave
Berkeley, CA 94704-1552 - Phone
- (510) 726-8226
- NPI assigned
- Oct 20, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3481 | OR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychologist | 103T00000X | 32615 | CA | Primary |
Addresses
Primary practice location
2375 Shattuck Ave
Berkeley, CA 94704-1552
Mailing address
290 Purdue Ave
Kensington, CA 94708-1137
Phone (727) 698-2440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 15, 2026 through Apr 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3481 | OR | MD | Psychologist |
| 32615 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694217600000",
"number": "1477925253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 PURDUE AVE",
"city": "KENSINGTON",
"state": "CA",
"postal_code": "947081137",
"telephone_number": "727-698-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 SHATTUCK AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041552",
"telephone_number": "510-726-8226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETTER",
"first_name": "CAROLINE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2023-09-09",
"certification_date": "2023-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "3481",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "32615",
"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 Sep 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.