Healthcare Provider Details

I. General information

NPI: 1790913960
Provider Name (Legal Business Name): ASHLEY BERRY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 VIA NONA MARIE STE. 304A
CARMEL CA
93923
US

IV. Provider business mailing address

3855 VIA NONA MARIE STE. 304A
CARMEL CA
93923
US

V. Phone/Fax

Practice location:
  • Phone: 805-861-4024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY28987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: