Active NPI
Jack Edison Berry, MD, PHD
- Psychiatry Physician
- San Francisco, CA
National Provider Identifier
1720729239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A190970
- Practice address
- 675 18TH St
San Francisco, CA 94143-4200 - Phone
- (415) 476-7527
- NPI assigned
- Apr 6, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A190970 | CA | Primary |
Addresses
Primary practice location
675 18TH St
San Francisco, CA 94143-4200
Mailing address
675 18TH St
San Francisco, CA 94143-4200
Phone (415) 476-7527
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A190970 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1720729239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 18TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941434200",
"telephone_number": "415-476-7527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 18TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941434200",
"telephone_number": "415-476-7527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "JACK",
"middle_name": "EDISON",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-06",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A190970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.