Active NPI
Christine Chang
- Mental Health Counselor
- Berkeley, CA
National Provider Identifier
1710360722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2222 Bancroft Way
#4300
Berkeley, CA 94720-4300 - Phone
- (510) 642-9336
- Fax
- (510) 642-2368
- NPI assigned
- Jul 8, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CA | Primary |
Addresses
Primary practice location
2222 Bancroft Way
#4300
Berkeley, CA 94720-4300
Mailing address
1590 Ontario Dr Apt 3
Sunnyvale, CA 94087-4346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 13, 2023 through Dec 13, 2027
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": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1710360722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1590 ONTARIO DR APT 3",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940874346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 BANCROFT WAY",
"address_2": "#4300",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947204300",
"telephone_number": "510-642-9336",
"fax_number": "510-642-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-08",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": null,
"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 Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.