Active NPI
Carina Grandison, PHD
- Clinical Neuropsychologist
- Berkeley, CA
National Provider Identifier
1801271432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY14667
- Practice address
- 2006 Dwight Way Ste 301
Berkeley, CA 94704-2633 - Phone
- (510) 704-1820
- NPI assigned
- Jul 24, 2015
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY14667 | CA | Primary |
Addresses
Primary practice location
2006 Dwight Way Ste 301
Berkeley, CA 94704-2633
Mailing address
2006 Dwight Way Ste 301
Berkeley, CA 94704-2633
Phone (510) 704-1820
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14667 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1801271432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2006 DWIGHT WAY STE 301",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042633",
"telephone_number": "510-704-1820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2006 DWIGHT WAY STE 301",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042633",
"telephone_number": "510-704-1820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDISON",
"first_name": "CARINA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-24",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY14667",
"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 Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.