Ember Ian Cook, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29064 Issued in CA

Practice address

2140 Shattuck Ave Ste 405
Berkeley, CA 94704-1214

Phone

(510) 206-0599

NPI assigned

Aug 21, 2012

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ember Ian Coredini Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1710235841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 SHATTUCK AVE STE 405",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041214",
            "telephone_number": "510-206-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 SHATTUCK AVE STE 405",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041214",
            "telephone_number": "510-206-0599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Deerwood Rd Ste 395",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945831530",
            "country_code": "US",
            "telephone_number": "925-400-9604 x3",
            "fax_number": "925-394-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "EMBER",
        "middle_name": "IAN",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMBER",
            "last_name": "COREDINI",
            "middle_name": "IAN",
            "prefix": "MS.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meaghan L Connors, M.D.
• Julie Conquest
• John Frederick Conrad, D.D.S.
• Ralph Contreras
• April Cook Suravallop, LMFT
• Justin T Cooke
• Deangela Cooks
• Jesse R Cooksey, INTERN
• Amber Kristin Cooley, MA, LMFT #52498
• Angela Burke Coon

• Clinical Psychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.