Active NPI
Mary Tennes, PH.D.
- Psychoanalysis Psychologist
- Berkeley, CA
National Provider Identifier
1871970996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalysis Psychologist
- License
- PSY10410
- Practice address
- 2417 Carleton St
Berkeley, CA 94704-3310 - Phone
- (510) 653-1313
- NPI assigned
- Apr 27, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | PSY10410 | CA | |
| Psychoanalysis Psychologist | 103TP0814X | PSY10410 | CA | Primary |
Addresses
Primary practice location
2417 Carleton St
Berkeley, CA 94704-3310
Mailing address
2417 Carleton St
Berkeley, CA 94704-3310
Phone (510) 653-1313
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 |
|---|---|---|---|
| PSY10410 | CA | MD | Psychoanalysis Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1871970996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 CARLETON ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043310",
"telephone_number": "510-653-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 CARLETON ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947043310",
"telephone_number": "510-653-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENNES",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-27",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "CA",
"license": "PSY10410",
"primary": false
},
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "CA",
"license": "PSY10410",
"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 Apr 27, 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.