Dr Kelley Bryan Gin, PSYD is a
Psychologist based in Berkeley, California. Dr Kelley Bryan Gin is licensed to practice in California (license number 20624) and his current practice location is
2711 Alcatraz Ave Ste 2, Berkeley, California. He can be reached at his office (for appointments etc.) via phone at
(510) 219-7091.
NPI number for Dr Kelley Bryan Gin is 1194870949 and his current mailing address is 2711 Alcatraz Ave Ste 2, Berkeley, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1194870949.
Healthcare Provider's Profile
| Full Name | Dr Kelley Bryan Gin |
|---|
| Gender | Male |
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| Speciality | Psychologist |
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| Location | 2711 Alcatraz Ave Ste 2, Berkeley, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194870949
- Provider Enumeration Date: 01/24/2007
- Last Update Date: 03/17/2018
Medical Identifiers
Medical identifiers for Dr Kelley Bryan Gin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194870949 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 106H00000X | Marriage & Family Therapist | MFC 38529 (California) | Secondary |
| 103T00000X | Psychologist | 20624 (California) | Primary |
| 103TC0700X | Psychologist - Clinical | PSY 20624 (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelley Bryan Gin is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelley Bryan Gin, PSYD
2711 Alcatraz Ave Ste 2,
Berkeley, CA 94705-2726
Ph: (510) 219-7091 | Dr Kelley Bryan Gin, PSYD
2711 Alcatraz Ave Ste 2,
Berkeley, CA 94705-2726
Ph: (510) 219-7091 |
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