MEDICARE: RESOLVE PSYCHOLOGICAL SERVICES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1598622946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOLVE PSYCHOLOGICAL SERVICES PC

Provider Business Mailing Address
First Line	:	2930 DOMINGO AVE UNIT 1017
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2930 DOMINGO AVE UNIT 1017
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:	406-551-6385
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMANTHA WHITE
Credential	:	PSYD
Telephone Number	:	406-551-6385

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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