Healthcare Provider Details

I. General information

NPI: 1962933218
Provider Name (Legal Business Name): ANNE HART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 DOMINGO AVE # 1327
BERKELEY CA
94705-2454
US

IV. Provider business mailing address

2930 DOMINGO AVE # 1327
BERKELEY CA
94705-2454
US

V. Phone/Fax

Practice location:
  • Phone: 415-484-6191
  • Fax:
Mailing address:
  • Phone: 415-484-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA11594300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC211515
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number310354
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number84438
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: