Active NPI
Anne C Bernstein, PH.D.
- Family Psychologist
- Berkeley, CA
National Provider Identifier
1558371658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- PSY4290
- Practice address
- 2955 Shattuck Ave # 12
Berkeley, CA 94705-1808 - Phone
- (510) 549-0598
- NPI assigned
- Aug 9, 2006
- Last updated
- Oct 22, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY4290 | CA | |
| Family Psychologist | 103TF0000X | PSY4290 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | MFC5940 | CA |
Addresses
Primary practice location
2955 Shattuck Ave # 12
Berkeley, CA 94705-1808
Mailing address
2955 Shattuck Avenue #12
Berkeley, CA 94705-1808
Phone (510) 549-0598
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MFCC5940 | Other | CA | MARR & FAM THERAPIST LIC |
| PSY4290 | Other | CA | PSYCHOLOGIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC5940 | CA | MD | Marriage & Family Therapist |
| 4290 | CA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287705600000",
"number": "1558371658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2955 SHATTUCK AVENUE #12",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051808",
"telephone_number": "510-549-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 SHATTUCK AVE # 12",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051808",
"telephone_number": "510-549-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNSTEIN",
"first_name": "ANNE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2010-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY4290",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "CA",
"license": "PSY4290",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC5940",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARR & FAM THERAPIST LIC",
"identifier": "MFCC5940",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "PSY4290",
"state": "CA"
}
],
"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 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.