Individual provider Active NPI

Carla Elizabeth Haimowitz, PHD

  • Psychologist
  • Oakland, CA
National Provider Identifier
1912015124
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY143250 Issued in CA
Practice address
5108 Manila Ave
Oakland, CA 94618-1020
Phone
(510) 655-7828
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY143250 CA Primary
Marriage & Family Therapist 106H00000X MFT7388 CA

Addresses

Primary practice location

5108 Manila Ave
Oakland, CA 94618-1020

Mailing address

5108 Manila Ave
Oakland, CA 94618-1020
Phone (510) 655-7828

Other identifiers 1

IdentifierTypeStateIssuer
PSY14325MedicaidCA

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
I20101129000808 CA Practitioner - Clinical Psychologist 8921294216 Practice locations: Oakland, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5108 Manila Ave
Oakland, CA 94618-1020
Phone (510) 655-7828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY143250CAMDPsychologist
MFT7388CAMDMarriage & Family Therapist
14325CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1912015124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 MANILA AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181020",
            "telephone_number": "510-655-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 MANILA AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181020",
            "telephone_number": "510-655-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIMOWITZ",
        "first_name": "CARLA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY143250",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT7388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY14325",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.