Healthcare Provider Details

I. General information

NPI: 1154288538
Provider Name (Legal Business Name): NOAH M COLLINS PHD PSYCHOLOGIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 PERALTA AVE
BERKELEY CA
94707-1842
US

IV. Provider business mailing address

768 PERALTA AVE
BERKELEY CA
94707-1842
US

V. Phone/Fax

Practice location:
  • Phone: 510-982-5337
  • Fax:
Mailing address:
  • Phone: 510-982-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: NOAH MATTHEW COLLINS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 510-982-5337