Active NPI
Kin Ming Chan
- Counseling Psychologist
- Berkeley, CA
National Provider Identifier
1982844395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 2222 Bancroft Way
Tang Center UC Berkeley
Berkeley, CA 94720-4300 - Phone
- (510) 642-9494
- NPI assigned
- Feb 25, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
2222 Bancroft Way
Tang Center UC Berkeley
Berkeley, CA 94720-4300
Mailing address
4916 Omar St
Fremont, CA 94538-3248
Phone (510) 996-8449
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1982844395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4916 OMAR ST",
"city": "FREMONT",
"state": "CA",
"postal_code": "945383248",
"telephone_number": "510-996-8449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 BANCROFT WAY",
"address_2": "TANG CENTER UC BERKELEY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947204300",
"telephone_number": "510-642-9494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "KIN MING",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-25",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"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 Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.