Active NPI
Mark Steven Barajas, PHD, LP
- Counseling Psychologist
- Berkeley, CA
National Provider Identifier
1609200385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 30042
- Practice address
- 2140 Shattuck Ave Ste 809
Berkeley, CA 94704-1229 - Phone
- (510) 969-0758
- NPI assigned
- Aug 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301015413 | MI | |
| Counseling Psychologist | 103TC1900X | 30042 | CA | Primary |
Addresses
Primary practice location
2140 Shattuck Ave Ste 809
Berkeley, CA 94704-1229
Mailing address
1928 St. Mary'S Road
Department of Psychology
Moraga, CA 94575-2744
Phone (925) 631-8009
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015413 | MI | MD | Counseling Psychologist |
| 30042 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1609200385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1928 ST. MARY'S ROAD",
"address_2": "DEPARTMENT OF PSYCHOLOGY",
"city": "MORAGA",
"state": "CA",
"postal_code": "945752744",
"telephone_number": "925-631-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 SHATTUCK AVE STE 809",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041229",
"telephone_number": "510-969-0758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARAJAS",
"first_name": "MARK",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PHD, LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-29",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301015413",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "30042",
"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 May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.