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NPI Code Detail

MEDICARE: DR. ALISA CASTLETON NOWIK PSY.D.

MEDICARE: DR. ALISA CASTLETON NOWIK PSY.D.
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
1103TC0700XClinical PsychologistPSY21587CA
2103TC0700XClinical Psychologist016438NY
3103TC2200XClinical Child & Adolescent PsychologistPSY21587CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1016438OTHERNYNYS PSYD LICENSE #
2PSY 21587OTHERCA LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4461699OTHERCAMHN INSURANCE

General Provider Information

NPI Number : 1346292661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALISA CASTLETON NOWIK PSY.D.
Provider Business Mailing Address
First Line : 3036 REGENT STREET
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2551
Country : US
Telephone Number : 650-644-5358
Fax Number : 888-841-0506
Provider Business Practice Location Address
First Line : 3036 REGENT STREET
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2551
Country : US
Telephone Number : 650-644-5358
Fax Number : 888-841-0506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 12/15/2022

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