CARMEN FONG (NPI# 1073777009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073777009 |
| Entity Type | Individual |
| Full Name | CARMEN FONG |
| Practice Address |
3075 Adeline St Suite 120 Berkeley CA 94703-2576 |
| Practice Telephone | 5108481112 |
| Practice Fax Number | 5108484445 |
| Mailing Telephone | 5108481112 |
| Mailing Fax Number | 5108484445 |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2012-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417290768 | Carmen Frances Fong | Student in an Organized Health Care Education/Training Program | 353 E 17th St Fl 2, Beth Israel Medical Center, New York, NY 10003-3821 | 2013-04-04 |
| Street Address |
3075 ADELINE ST SUITE 120 |
| City | BERKELEY |
| State | CA |
| Zip Code | 94703-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730211368 | Linda K. Frankel | Psychiatry & Neurology | 3075 Adeline St, Suite 280, Berkeley, CA 94703-2576 | 2007-03-09 |
| 1972021095 | Gabriella Rochelle Ruzin | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Berkeley, CA 94703-2576 | 2017-09-08 |
| 1568996106 | Robin Ann Weber | Social Worker | 3075 Adeline St, 120, Berkeley, CA 94703-2576 | 2017-04-19 |
| 1326590688 | Alysha Swaim Aziz | Registered Nurse | 3075 Adeline St, St #280, Berkeley, CA 94703-2576 | 2016-11-02 |
| 1790234466 | Marco Antonio Gomez | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2016-09-22 |
| 1679944169 | Melanie Marusczak | Nurse Practitioner | 3075 Adeline St, Ste 280, Berkeley, CA 94703-2576 | 2015-10-09 |
| 1376911123 | Theresia Anderson | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Ste 120, Berkeley, CA 94703-2576 | 2015-09-10 |
| 1659749422 | Lori Lee | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2015-09-09 |
| 1316372501 | Kaeonadda Mindy Jitmanowan | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2013-09-06 |
| 1144655614 | Kuldip Raju | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2013-09-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553621 | Brittney Jerrilena Monique Garrett | Behavioral Analyst | 1901 Stuart St, Berkeley, CA 94703 | 2019-05-16 |
| 1740762178 | Maryam Jabbari Amiri | Student in an Organized Health Care Education/Training Program | 3075 Adeline Street, Suite 120, Berkeley, CA 94703 | 2018-09-01 |
| 1619427549 | Sigal Gafni | Occupational Therapist | 1622 Parker St. Apt. 1, Berkeley, CA 94703 | 2016-10-04 |
| 1750741138 | Ane Becker | Community Health Worker | 2026 Woolsey St, Berkeley, CA 94703 | 2016-02-29 |
| 1245697135 | Sara Dinome Teel Vargas | Chiropractor | 3286 Adeline St., Suite 9, Berkeley, CA 94703 | 2016-01-22 |
| 1083081608 | Olivia Debree | Nurse Practitioner | 3075 Adeline Street, Suite 280, Lifelong Medical Care, Ashby Health Center, Berkeley, CA 94703 | 2015-08-31 |
| 1962885988 | Caro Grosvenor | Marriage & Family Therapist | 1511 Ada Street, Berkeley, CA 94703 | 2015-07-08 |
| 1619378452 | Myles Malone | Counselor | 2413 Jefferson Ave., Berkeley, CA 94703 | 2014-09-11 |
| 1013340223 | Denise Daniel | Acupuncturist | 6222 La Salle Ave Suite B, Oakland, CA 94703 | 2013-08-12 |
| 1104126200 | Iramis Kouromenos | Dental Hygienist | 1721 University Ave Apt#209, Berkeley, CA 94703 | 2010-10-25 |
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| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760942148 | Sharon Joy Avesar | Counselor | 2218 Prince St Unit A, Berkeley, CA 94705-1819 | 2019-03-22 |
| 1295229318 | Kelly Michelle Whiteford | Counselor | 3001 Telegraph Ave Apt 403, Berkeley, CA 94705-2164 | 2018-06-21 |
| 1083108575 | Romy-michelle Alexandra Unger | Counselor | 2838 Mcgee Ave Apt A, Berkeley, CA 94703-2066 | 2018-06-18 |
| 1154824126 | Stephanie Lemus | Counselor | 2484 Shattuck Ave Ste 201, Berkeley, CA 94704-2076 | 2018-03-15 |
| 1215455761 | Christine Libbey | Counselor | 1980 Hopkins St, Berkeley, CA 94707-2634 | 2017-09-05 |
| 1205371994 | Hayley Elizabeth Liddle | Counselor | 1533b Prince St, Berkeley, CA 94703-2309 | 2017-01-04 |
| 1790158038 | Utah Powell | Counselor | 1422 Fairview St, Berkeley, CA 94702-2716 | 2015-11-09 |
| 1437550720 | Paulina Montes | Counselor | 2540 Grant St, Berkeley, CA 94703-1948 | 2014-09-05 |
| 1013318344 | Lyudmila Kuznetsova | Counselor | 1922 Stuart St, Berkeley, CA 94703-2215 | 2014-09-05 |
| 1972856839 | Kathleen Anne Ruffulo | Counselor | 1212 N Ashbel Ave, Berkeley, IL 60163-1118 | 2012-10-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.