KEITH TRIBBLE (NPI# 1306451364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306451364 |
| Entity Type | Individual |
| Full Name | KEITH TRIBBLE |
| Credential | SUDCC |
| Practice Address |
1835 Allston Way Berkeley CA 94703-1764 |
| Practice Telephone | 5106669552 |
| Mailing Telephone | 5106669552 |
| Mailing Fax Number | 5106669099 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
9357 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1835 ALLSTON WAY |
| City | BERKELEY |
| State | CA |
| Zip Code | 94703-1764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598092462 | Justin Paul Phillips | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2009-11-12 |
| 1841890571 | Jose Rolando Ayala | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2020-10-30 |
| 1265030621 | Matthew Thomas Brady | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2020-10-16 |
| 1235757782 | Tith Ton | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2020-07-10 |
| 1447870019 | Samuel Arola Strange | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2020-04-23 |
| 1457911968 | Yvonne Annette Tate | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2019-06-17 |
| 1316506991 | Michelle Joe | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2019-06-07 |
| 1396209292 | Teena R Wright | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2019-01-24 |
| 1487125142 | Amin Miraftab | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2018-12-06 |
| 1821566704 | Jennifer Nicole Caldwell | Marriage & Family Therapist | 1835 Allston Way, Berkeley, CA 94703-1764 | 2018-11-08 |
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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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275152324 | Nicholas Michael Jester | Counselor | 1610 Milvia St Apt 2, Berkeley, CA 94709-2047 | 2020-04-09 |
| 1497267967 | Merlenet Michelle Riley | Counselor | 2640 Martin Luther King, Berkeley, CA 94704 | 2017-10-24 |
| 1629429790 | Pearl Ortiz | Counselor | 1280 University Ave Apt D, Berkeley, CA 94702-1762 | 2016-06-29 |
| 1417352634 | Aous Jarrar | Counselor | 1931 Center St., Berkeley, CA 94704-1105 | 2014-10-30 |
| 1619378452 | Myles Malone | Counselor | 2413 Jefferson Ave., Berkeley, CA 94703 | 2014-09-11 |
| 1699192369 | Elaine Gram | Counselor | 1942 University Ave Ste 208, Berkeley, CA 94704-1073 | 2014-03-19 |
| 1285078378 | Verona Lyn | Counselor | 1931 Center Street, Berkeley, CA 94704 | 2013-04-19 |
| 1407167117 | Preston Vargas | Counselor | 3051 Adeline St, Berkeley, CA 94703-2523 | 2010-06-28 |
| 1598092462 | Justin Paul Phillips | Counselor | 1835 Allston Way, Berkeley, CA 94703-1764 | 2009-11-12 |
| 1679778864 | Ben C Pryor | Counselor | Ben Pryor 998 Virginia St, Berkeley, CA 94710-1851 | 2007-06-18 |
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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.