Ellen Zucker, PH.D.

Key facts

NPI

1902020134

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Psychologist 103TC0700X

License

PSY4508 (CA)

Practice address

762 Hilldale Ave
Berkeley, CA 94708-1318

Phone

(510) 708-2525

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Philosophy

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 25, 2021.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640390400000",
    "number": "1902020134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 HILLDALE AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081318",
            "telephone_number": "510-708-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 HILLDALE AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081318",
            "telephone_number": "510-708-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKER",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-12-25",
        "certification_date": "2021-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

• Karen Michelle Zojaji, L.AC.
• Roland Zoller
• Zeynep Zorlu
• Kristina Elaine Zoulas, D.D.S.
• Emily Zubritsky
• Jeri L Zukoski, C.N.M.
• Brad Aaron Zwahlen, M.D.
• Joan Ellen Zweben, PH.D.
• Leeat Zwick-Louvton, P.T.
• Monique Zwicker

All providers in Berkeley, CA · Clinical Psychologist in California