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Dr. Kelley Bryan Gin , PsyD

Psychologist β€’ Berkeley, CA

Active NPI 1194870949 Individual Practitioner Male Practitioner
Practice location in NPPES

2711 Alcatraz Ave Ste 2
Berkeley, CA 947052726

Call 5102197091 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2711 Alcatraz Ave Ste 2

Berkeley, CA 947052726

Telephone 5102197091
Fax 5102699031
Organization at the Same NPPES Address or Phone
Kelley Bryan Gin, Psyd Facility NPI 1972072023

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Oakland, CA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Berkeley and California

118 active clinicians are listed under Psychologist with a practice address in Berkeley, CA (7,305 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Berkeley

6.8% of these 118 clinicians have the CMS telehealth indicator.

16.1% of these 118 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES CA 20624

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Marriage & Family Therapist

NUCC Taxonomy Code: 106H00000X

License # reported to NPPES CA MFC 38529

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES CA PSY 20624

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 breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Secondary Practice Locations

3301 E 12th St, Suite 259

Oakland, CA 946013424

Phone: 5102699042

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Psychologist (license number reported to NPPES: CA PSY 20624)

βœ…
NPI Profile Active February 05, 2018

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location February 05, 2018

Registered at 2711 ALCATRAZ AVE STE 2, BERKELEY, CA 947052726 (Tel: 5102197091)

πŸ“
Updated Business Mailing Address February 05, 2018

Registered at 2711 ALCATRAZ AVE STE 2, BERKELEY, CA 947052726 (Tel: 5102197091)

πŸ‘€
Provider Name / Credentials Updated February 05, 2018

Recorded as KELLEY GIN, PSYD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2018

Marriage & Family Therapist (license number reported to NPPES: CA MFC 38529)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2018

Psychologist (license number reported to NPPES: CA 20624)

βœ…
NPI Profile Active June 11, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 11, 2010

Registered at 3301 E 12TH ST, SUITE 259, OAKLAND, CA 946013424 (Tel: 5102699042)

πŸ“
Business Mailing Address (Initial Record) June 11, 2010

Registered at 3301 E 12TH ST, SUITE 259, OAKLAND, CA 946013424 (Tel: 5102699042)

πŸ‘€
Provider Name / Credentials (Initial Record) June 11, 2010

Recorded as KELLEY GIN, PSYD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 11, 2010

Psychologist (license number reported to NPPES: CA PSY 20624)

🟒
Initial NPI Registration & Enumeration January 24, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1194870949
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 24, 2007
Last Update: March 17, 2018
Sole Proprietor: Yes

Other Psychologists in Berkeley

All Psychologists in Berkeley

Mailing Address

2711 Alcatraz Ave Ste 2

Berkeley, CA 947052726

Phone: 5102197091

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.