Ankhesenamun Ball Marioni, PSY.D
Individual provider Active NPI Psychologist · Oakland, CA
NPI 1760645998 · NPPES record last updated Nov 13, 2023
Key facts
- NPI
- 1760645998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 24781 (CA)
- Practice address
- 600 Grand Ave Ste 301
Oakland, CA 94610-3548 - Phone
- (510) 269-7607
- NPI assigned
- Jul 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1371 Green Ravine Dr
Lincoln, CA 95648-8033
Phone 80062461900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250403001888 | CA | Practitioner - Clinical Psychologist | 2466976162 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24781 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Being, a Psychological Corporation | Clinical Neuropsychologist | Current |
Accepting new patients |
Locations
1760 Solano Ave
Ste 206
Berkeley, CA 94707
Phone (800) 624-6190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist |
103G00000X | |||
| Forensic Psychologist |
103TF0200X | |||
| Psychologist | 103T00000X | 24781 | CA | Yes |
Addresses
Primary practice location
600 Grand Ave Ste 301
Oakland, CA 94610-3548
Mailing address
1918 Bonita Ave # 200
Berkeley, CA 94704-1014
Phone (510) 269-7607
Other names
- Ankhesenamun Ball
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.