Active NPI
William Frederick Riess, PH.D.
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1700969235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY2810
- Practice address
- 2417 Carleton St
Berkeley, CA 94704-3310 - Phone
- (510) 845-6892
- Fax
- (510) 845-5489
- NPI assigned
- Oct 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY2810 | CA | Primary |
Addresses
Primary practice location
2417 Carleton St
Berkeley, CA 94704-3310
Mailing address
2417 Carleton St
Berkeley, CA 94704-3310
Phone (510) 845-6892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY2810 | Other | CA | BLUE SHIELD/BLUE CROSS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700969235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 CARLETON ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043310",
"telephone_number": "510-845-6892",
"fax_number": "510-845-5489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 CARLETON ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043310",
"telephone_number": "510-845-6892",
"fax_number": "510-845-5489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIESS",
"first_name": "WILLIAM",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY2810",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD/BLUE CROSS",
"identifier": "PSY2810",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.