Active NPI
Amanda Bean Hannigan, PSY.D.
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1649679499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32349
- Practice address
- 2428 Dwight Way Ste No7
Berkeley, CA 94704-3506 - Phone
- (617) 513-8770
- NPI assigned
- Aug 18, 2014
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | CA | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Clinical Psychologist | 103TC0700X | 32349 | CA | Primary |
Addresses
Primary practice location
2428 Dwight Way Ste No7
Berkeley, CA 94704-3506
Mailing address
PO Box 138
Berkeley, CA 94701-0138
Phone (617) 513-8770
Other practice location 1
2425 Bisso Ln Ste 200
Concord, CA 94520-4886
Phone (925) 521-5767
Other practice location 2
3260 Blume Dr Ste 450
Richmond, CA 94806-5115
Phone (510) 262-6551
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611446400000",
"number": "1649679499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 138",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947010138",
"telephone_number": "617-513-8770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2428 DWIGHT WAY STE NO7",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043506",
"telephone_number": "617-513-8770"
}
],
"practiceLocations": [
{
"address_1": "2425 Bisso Ln Ste 200",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "CA",
"postal_code": "945204886",
"country_code": "US",
"telephone_number": "925-521-5767",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3260 Blume Dr Ste 450",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "CA",
"postal_code": "948065115",
"country_code": "US",
"telephone_number": "510-262-6551",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HANNIGAN",
"first_name": "AMANDA",
"middle_name": "BEAN",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2021-01-24",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32349",
"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 Jan 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.