Individual provider Active NPI

Doris Bersing, PHD

  • Clinical Psychologist
  • Sausalito, CA
National Provider Identifier
1902848336
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19255 Issued in CA
Practice address
202 Donahue St
Sausalito, CA 94965-1029
Phone
(877) 824-5840
NPI assigned
Jun 11, 2006
Last updated
Oct 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY19255 CA Primary

Addresses

Primary practice location

202 Donahue St
Sausalito, CA 94965-1029

Mailing address

202 Donahue St
Sausalito, CA 94965-1029
Phone (415) 331-4521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060706000417 CA Practitioner - Clinical Psychologist 0244242477 Practice locations: Sausalito, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

202 Donahue St
Sausalito, CA 94965-1029
Phone (877) 824-5840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY19255CAMDClinical Psychologist
19255CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Psychological Testing Assoc PastSince Oct 11, 2020 Accepting new patients
Pacific Institute PastSince Mar 1, 2008 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1902848336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 DONAHUE ST",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651029",
            "telephone_number": "415-331-4521",
            "fax_number": "415-331-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 DONAHUE ST",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651029",
            "telephone_number": "877-824-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSING",
        "first_name": "DORIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

Verify at the official NPI Registry.