Active NPI
Samuel Alfred Herbert, PHD
- Clinical Psychologist
- Oak Harbor, WA
National Provider Identifier
1811040785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 8228
- Practice address
- 3475 N Saratoga St
Oak Harbor, WA 98278-4927 - Phone
- (360) 257-9859
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 Psychologist | 103TC0700X | PSY 8228 | CA | Primary |
Addresses
Primary practice location
3475 N Saratoga St
Oak Harbor, WA 98278-4927
Mailing address
316 SE Pioneer Way
#528
Oak Harbor, WA 98277-5716
Phone (408) 426-7404
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 |
|---|---|---|---|
| PSY 8228 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811040785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 SE PIONEER WAY",
"address_2": "#528",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982775716",
"telephone_number": "408-426-7404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 N SARATOGA ST",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982784927",
"telephone_number": "360-257-9859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERBERT",
"first_name": "SAMUEL",
"middle_name": "ALFRED",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 8228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.