Active NPI
Stephen John Berger, PSY.D.
- Psychologist
- Patton, CA
National Provider Identifier
1831151224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS008599L
- Practice address
- 3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369 - Phone
- (909) 425-7679
- Fax
- (909) 425-6635
- NPI assigned
- Apr 3, 2006
- Last updated
- Aug 26, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS008599L | PA | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | PS008599L | PA |
Addresses
Primary practice location
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Mailing address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 809366 | Other | PA | FIRST PRIORITY HEALTH |
| 0017638180002 | Medicaid | PA | |
| 481729 | Other | PA | HIGHMARK BLUE SHIELD |
| R34049 | Other | PA | HEALTHAMERICA |
| 467613 | Other | PA | VALUE OPTIONS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS008599L | PA | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1831151224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 E. HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7679",
"fax_number": "909-425-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3102 E. HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7679",
"fax_number": "909-425-6635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGER",
"first_name": "STEPHEN",
"middle_name": "JOHN",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-03",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS008599L",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "PA",
"license": "PS008599L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "809366",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017638180002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "481729",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHAMERICA",
"identifier": "R34049",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "467613",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Patton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.