MEDICARE: NOAH M COLLINS PHD PSYCHOLOGIST INC

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	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1154288538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOAH M COLLINS PHD PSYCHOLOGIST INC

Provider Business Mailing Address
First Line	:	768 PERALTA AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-1842
Country	:	US
Telephone Number	:	510-982-5337
Fax Number	:

Provider Business Practice Location Address
First Line	:	768 PERALTA AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-1842
Country	:	US
Telephone Number	:	510-982-5337
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NOAH MATTHEW COLLINS
Credential	:	PH.D.
Telephone Number	:	510-982-5337

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

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