Active NPI
Heather Keith Macdonald, MA, PSY.D.
- Clinical Child & Adolescent Psychologist
- Berkeley, CA
National Provider Identifier
1508015991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 23533
- Practice address
- 2625 Alcatraz Ave
Berkeley, CA 94705-2702 - Phone
- (510) 282-7677
- NPI assigned
- Sep 10, 2008
- 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 Child & Adolescent Psychologist | 103TC2200X | 23533 | CA | Primary |
Addresses
Primary practice location
2625 Alcatraz Ave
Berkeley, CA 94705-2702
Mailing address
2625 Alcatraz Ave
Berkeley, CA 94705
Phone (510) 282-7677
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23533 | CA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1508015991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 ALCATRAZ AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94705",
"telephone_number": "510-282-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 ALCATRAZ AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052702",
"telephone_number": "510-282-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "HEATHER",
"middle_name": "KEITH",
"name_prefix": "Ms.",
"credential": "MA, PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-10",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "23533",
"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 Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.