Active NPI
Annice Ormiston, PSYD
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1942588181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25092
- Practice address
- 2000 Hearst Ave Ste 207
Berkeley, CA 94709-2260 - Phone
- (510) 852-9322
- Fax
- (888) 972-2231
- NPI assigned
- Jul 21, 2011
- Last updated
- Dec 11, 2020
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 25092 | CA | Primary |
Addresses
Primary practice location
2000 Hearst Ave Ste 207
Berkeley, CA 94709-2260
Mailing address
2000 Hearst Ave Ste 207
Berkeley, CA 94709-2260
Phone (510) 852-9322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120814000165 | CA | Practitioner - Psychologist Billing Independently | 6901052547 | Practice locations: Berkeley, CA; San Rafael, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2000 Hearst Ave
Suite 207
Berkeley, CA 94709-2260
Phone (510) 852-9322
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25092 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1942588181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 HEARST AVE STE 207",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947092260",
"telephone_number": "510-852-9322",
"fax_number": "888-972-2231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 HEARST AVE STE 207",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947092260",
"telephone_number": "510-852-9322",
"fax_number": "888-972-2231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORMISTON",
"first_name": "ANNICE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-21",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25092",
"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 Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.