Individual provider Active NPI

Ahmed Sabry El-Sokkary, PSYD

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1619169380
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 19049 Issued in CA
Practice address
1970 Broadway Ste 835
Oakland, CA 94612-2299
Phone
(415) 596-1372
Fax
(888) 506-6612
NPI assigned
Aug 15, 2007
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X PSY 19049 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X 19049 CA

Addresses

Primary practice location

1970 Broadway Ste 835
Oakland, CA 94612-2299

Mailing address

1970 Broadway Ste 835
Oakland, CA 94612-2299
Phone (415) 596-1372

Other identifiers 1

IdentifierTypeStateIssuer
26-0215657MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024001309 AZ Practitioner - Clinical Psychologist 8224118393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 19049CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Psychiatry Inc CurrentSince Jul 20, 2020 Accepting new patients
Bodner Chiropractic Professional Corporation Past Accepting new patients
Ocean Psychological Services, Inc. Psychologist PastSince Nov 16, 2021 Accepting new patients

Locations

39180 Liberty St
Ste 205
Fremont, CA 94538
Phone (510) 439-0657

39210 State St
Ste 100
Fremont, CA 94538
Phone (510) 399-7080

292 Ocean Ave
San Francisco, CA 94112
Phone (415) 586-2222

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1619169380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 BROADWAY STE 835",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122299",
            "telephone_number": "415-596-1372",
            "fax_number": "510-452-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 BROADWAY STE 835",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122299",
            "telephone_number": "415-596-1372",
            "fax_number": "888-506-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-SOKKARY",
        "first_name": "AHMED",
        "middle_name": "SABRY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 19049",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "19049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-0215657",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.