Active NPI
Mary Katherine Macvicar, M.D.
- Psychiatry Physician
- Berkeley, CA
National Provider Identifier
1891077277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A22343
- Practice address
- 2702 Dana St
Berkeley, CA 94705-1136 - Phone
- (510) 849-1330
- NPI assigned
- Sep 12, 2011
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A22343 | CA | Primary |
Addresses
Primary practice location
2702 Dana St
Berkeley, CA 94705-1136
Mailing address
2702 Dana St
Berkeley, CA 94705-1136
Phone (510) 849-1330
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A22343 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1891077277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2702 DANA ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051136",
"telephone_number": "510-849-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2702 DANA ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051136",
"telephone_number": "510-849-1330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACVICAR",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A22343",
"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 Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.