Individual provider Active NPI

Gregg E Bernstein, PH.D.

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1730409343
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4840 Issued in CA
Practice address
19 Glen Eden Ave
Oakland, CA 94611-4316
Phone
(510) 652-0837
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY4840 CA Primary

Addresses

Primary practice location

19 Glen Eden Ave
Oakland, CA 94611-4316

Mailing address

19 Glen Eden Ave
Oakland, CA 94611-4316
Phone (510) 652-0837

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

State licenses

LicenseStateTypeSpecialty
PSY4840CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1730409343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GLEN EDEN AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114316",
            "telephone_number": "510-652-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 GLEN EDEN AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114316",
            "telephone_number": "510-652-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "GREGG",
        "middle_name": "E",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.