Active NPI
Judith Elkin, PH.D.
- Psychologist
- Oakland, CA
National Provider Identifier
1760649149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY8774
- Practice address
- 4283 Piedmont Ave
Ste. F4
Oakland, CA 94611-4713 - Phone
- (510) 654-0245
- Fax
- (510) 654-0245
- NPI assigned
- May 22, 2008
- Last updated
- May 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY8774 | CA | Primary |
Addresses
Primary practice location
4283 Piedmont Ave
Ste. F4
Oakland, CA 94611-4713
Mailing address
4283 Piedmont Ave
Ste. F4
Oakland, CA 94611-4713
Phone (510) 654-0245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231121000763 | CA | Practitioner - Psychologist Billing Independently | 9537517164 | Practice locations: Oakland, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8774 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1760649149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4283 PIEDMONT AVE",
"address_2": "STE. F4",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946114713",
"telephone_number": "510-654-0245",
"fax_number": "510-654-0245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4283 PIEDMONT AVE",
"address_2": "STE. F4",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946114713",
"telephone_number": "510-654-0245",
"fax_number": "510-654-0245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKIN",
"first_name": "JUDITH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY8774",
"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 May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.