Active NPI
Jacob Kaminker, PHD
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1700102977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 26445
- Practice address
- 1918 Bonita Ave # 208
Berkeley, CA 94704-1014 - Phone
- (510) 995-6358
- NPI assigned
- Apr 13, 2010
- 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 | PSY 26445 | CA | |
| Clinical Psychologist | 103TC0700X | PSY 26445 | CA | Primary |
Addresses
Primary practice location
1918 Bonita Ave # 208
Berkeley, CA 94704-1014
Mailing address
1918 Bonita Ave # 208
Berkeley, CA 94704-1014
Phone (510) 995-6358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY 26445 | Other | CA | LICENSED CLINICAL PSYCHOLOGIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2021 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 26445 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1700102977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1918 BONITA AVE # 208",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041014",
"telephone_number": "510-995-6358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1918 BONITA AVE # 208",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041014",
"telephone_number": "510-995-6358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMINKER",
"first_name": "JACOB",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-13",
"last_updated": "2026-01-15",
"certification_date": "2026-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY 26445",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 26445",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CLINICAL PSYCHOLOGIST",
"identifier": "PSY 26445",
"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 Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.