Active NPI
Amber Dawn Berry
- Professional Counselor
- Escondido, CA
National Provider Identifier
1922539758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8964
- Practice address
- 490 N Grape St
Escondido, CA 92025-3079 - Phone
- (760) 975-9939
- NPI assigned
- Mar 23, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 8964 | CA | Primary |
| Mental Health Counselor | 101YM0800X | 8964 | CA |
Addresses
Primary practice location
490 N Grape St
Escondido, CA 92025-3079
Mailing address
490 N Grape St
Escondido, CA 92025-3079
Phone (760) 975-9939
Other practice location 1
3491 Kurtz St
San Diego, CA 92110-4430
Phone (619) 320-2404
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8964 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708732800000",
"number": "1922539758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 N GRAPE ST",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253079",
"telephone_number": "760-975-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 N GRAPE ST",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253079",
"telephone_number": "760-975-9939"
}
],
"practiceLocations": [
{
"address_1": "3491 Kurtz St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921104430",
"country_code": "US",
"telephone_number": "619-320-2404",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERRY",
"first_name": "AMBER",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2024-02-24",
"certification_date": "2024-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "8964",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "8964",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.