Individual provider Active NPI

Teresa Susan Gjernes, PSY

  • Clinical Psychologist
  • Berkeley, CA
National Provider Identifier
1760690507
Registry record updated Jan 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19467 Issued in CA
Practice address
2824 College Ave
Berkeley, CA 94705-2114
Phone
(510) 585-6336
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2026

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 PSY19467 CA Primary

Addresses

Primary practice location

2824 College Ave
Berkeley, CA 94705-2114

Mailing address

678 Fairview St
Oakland, CA 94609-1014
Phone (510) 585-6336

Other names 1

  • Dr. Terese Susan Gjernes Professional name

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

State licenses

LicenseStateTypeSpecialty
PSY19467CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769212800000",
    "number": "1760690507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 FAIRVIEW ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091014",
            "telephone_number": "510-585-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 COLLEGE AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052114",
            "telephone_number": "510-585-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJERNES",
        "first_name": "TERESA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2026-01-24",
        "certification_date": "2026-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESE",
            "last_name": "GJERNES",
            "middle_name": "SUSAN",
            "prefix": "DR.",
            "credential": "PSY 19467",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 24, 2026; 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.