Ryan Adams
Individual provider Active NPI Psychologist · Berkeley, CA
NPI 1588020382 · NPPES record last updated Jan 3, 2022
Key facts
- NPI
- 1588020382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 27603 (CA)
- Practice address
- 3120 Telegraph Ave Ste 8
Berkeley, CA 94705-1965 - Phone
- (510) 766-0112
- NPI assigned
- Jan 8, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27603 | CA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 27603 | CA | Yes |
Addresses
Primary practice location
3120 Telegraph Ave Ste 8
Berkeley, CA 94705-1965
Mailing address
324 Macarthur Way
Brentwood, CA 94513-4649
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.