Individual provider Active NPI

Joel Kreisberg, DC, CCH

  • Nutrition Chiropractor
  • Berkeley, CA
National Provider Identifier
1740602200
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
28109 Issued in CA
Practice address
863 Arlington Ave
Berkeley, CA 94707-1926
Phone
(510) 558-7285
NPI assigned
Jan 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 28109 CA Primary

Addresses

Primary practice location

863 Arlington Ave
Berkeley, CA 94707-1926

Mailing address

863 Arlington Ave
Berkeley, CA 94707-1926
Phone (510) 558-7285

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1740602200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 ARLINGTON AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947071926",
            "telephone_number": "510-558-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 ARLINGTON AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947071926",
            "telephone_number": "510-558-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISBERG",
        "first_name": "JOEL",
        "credential": "DC, CCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "28109",
            "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 Jan 16, 2014; 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.