Kelley Bryan Gin is a Clinical in Berkeley, California. Kelley Bryan Gin practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kelley Bryan Gin is 1194870949. The last update date is 2018-03-17.
Kelley Bryan Gin's current location address is 2711 Alcatraz Ave Ste 2, Berkeley, California. You can contact this provider via phone number 5102197091 and fax number 5102699031. The mailing address for Kelley Bryan Gin is 2711 Alcatraz Ave Ste 2, Berkeley, California. To know further, please read the information below!
Provider Profile Detail
Provider Name | Kelley Bryan Gin |
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Address | 2711 Alcatraz Ave Ste 2, Berkeley, California |
Phone Number | 5102197091 |
Fax Number | 5102699031 |
Sole Proprietor | Y |
Credentials | PSYD |
NPI Number Detail
NPI Number | 1194870949 |
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Provider Enumeration Date | 2007-01-24 |
Last Updated Date | 2018-03-17 |
Provider Mailing Address Detail
Address | 2711 Alcatraz Ave Ste 2 |
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City | Berkeley |
State | California (CA) |
Post Code | 947052726 |
Phone Number | 5102197091 |
Fax Number | 5102699031 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 103Tc0700X |
Licence No | PSY 20624 |
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Kelley Bryan Gin by the Centers for Medicare & Medicaid Services (CMS)?
The Kelley Bryan Gin has been assigned the NPI (National Provider Identifier) 1194870949. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Kelley Bryan Gin located?
The Kelley Bryan Gin is located at 2711 Alcatraz Ave Ste 2, Berkeley, CA 947052726.
What is Kelley Bryan Gin's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kelley Bryan Gin is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
On what date did the Kelley Bryan Gin receive its 1194870949 assignment from the Centers for Medicare & Medicaid Services?
The Kelley Bryan Gin was assigned its 1194870949 by the Centers for Medicare & Medicaid Services on 2007-01-24.
As of what date was the information regarding Kelley Bryan Gin, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kelley Bryan Gin, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2018-03-17.
NPI Number: 1356344279
Address: Mount St. Mary's Hospital Laboratory, Lewiston, NY