Active NPI
Douglas Eliot Tucker, M.D.
- Psychiatry Physician
- Albany, CA
National Provider Identifier
1538344270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G054196
- Practice address
- 1498 Solano Ave
Albany, CA 94706-2148 - Phone
- (510) 496-6077
- Fax
- (510) 848-8699
- NPI assigned
- Dec 31, 2007
- Last updated
- Dec 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | G054196 | CA | |
| Forensic Psychiatry Physician | 2084F0202X | MD00047712 | WA | |
| Psychiatry Physician | 2084P0800X | G054196 | CA | Primary |
| Forensic Psychiatry Physician | 2084F0202X | IL |
Addresses
Primary practice location
1498 Solano Ave
Albany, CA 94706-2148
Mailing address
2887 College Ave
Suite 108
Berkeley, CA 94705-2154
Phone (510) 496-6077
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036096123 | IL | MD | Forensic Psychiatry Physician |
| MD00047712 | WA | MD | Forensic Psychiatry Physician |
| G054196 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1538344270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2887 COLLEGE AVE",
"address_2": "SUITE 108",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052154",
"telephone_number": "510-496-6077",
"fax_number": "510-848-8699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1498 SOLANO AVE",
"city": "ALBANY",
"state": "CA",
"postal_code": "947062148",
"telephone_number": "510-496-6077",
"fax_number": "510-848-8699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "DOUGLAS",
"middle_name": "ELIOT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-31",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "CA",
"license": "G054196",
"primary": false
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "WA",
"license": "MD00047712",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G054196",
"primary": true
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albany, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.