Individual provider Active NPI

Deborah Kory, PSYD

  • Psychologist
  • Berkeley, CA
National Provider Identifier
1992138929
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 25717 Issued in CA
Practice address
1905 Berkeley Way
Berkeley, CA 94704-1007
Phone
(510) 402-5221
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 25717 CA Primary

Addresses

Primary practice location

1905 Berkeley Way
Berkeley, CA 94704-1007

Mailing address

1905 Berkeley Way
Berkeley, CA 94704-1007
Phone (510) 402-5221

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
I20210730002215 CA Practitioner - Clinical Psychologist 9739582594 Practice locations: Albany, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

908 Tulare Ave
Albany, CA 94707-2112
Phone (510) 292-8136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 25717CAMDPsychologist
25717CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1992138929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 BERKELEY WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041007",
            "telephone_number": "510-402-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BERKELEY WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041007",
            "telephone_number": "510-402-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORY",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 25717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.