MR. JOHN FERGUS FAHY (NPI# 1588702740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588702740 |
| Entity Type | Individual |
| Full Name | MR. JOHN FERGUS FAHY |
| Other Name | MR. JACK FAHY |
| Credential | PH.D. |
| Practice Address |
2001 Dwight Way 5 North Berkeley CA 94704-2608 |
| Practice Telephone | 5102044896 |
| Practice Fax Number | 5102044655 |
| Mailing Telephone | 5102044896 |
| Mailing Fax Number | 5102044655 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | PSY14056 | CA | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | PSY14056 | CA | Behavioral Health & Social Service Providers |
| X | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
PSY14056 | CA | Behavioral Health & Social Service Providers |
| X | 103TR0400X |
Psychologist Specialization: Rehabilitation |
PSY14056 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225597321 | John Fahy | Student in an Organized Health Care Education/Training Program | Naval Medical Center San Diego, 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2019-03-18 |
| 1205069259 | John Patrick Fahy | Physical Therapist | 612 Corporate Way, Suite 7, Valley Cottage, NY 10989-2021 | 2009-08-25 |
| 1295789550 | John V. Fahy | Internal Medicine | 400 Parnassus Ave, San Francisco, CA 94143-2202 | 2006-05-20 |
| Street Address |
2001 DWIGHT WAY 5 NORTH |
| City | BERKELEY |
| State | CA |
| Zip Code | 94704-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738805 | Bay Area Rehabilitation Medical Group | Physical Medicine & Rehabilitation | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2005-05-27 |
| 1366083545 | Jamba Dolkar Tenzing | Nurse Practitioner | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2019-09-30 |
| 1013401983 | Lindsey Olander | Speech-Language Pathologist | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2018-06-14 |
| 1447604814 | Sutter Bay Hospitals | Psychiatric Unit | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2016-04-21 |
| 1235583360 | Mariam Kamyab | Registered Nurse | 2001 Dwight Way, Ste 1388, Berkeley, CA 94704-2608 | 2016-04-14 |
| 1336529106 | Alta Bates Summit Medical Center | Clinic/Center | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2015-06-05 |
| 1538563614 | Sutter East Bay Hospitals | Pharmacy | 2001 Dwight Way, Suite 2182, Berkeley, CA 94704-2608 | 2014-10-17 |
| 1821405192 | Altabates Comprehensive Cancer Center | Clinic/Center | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2014-07-17 |
| 1942624408 | Karri Kennedy | Occupational Therapist | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2014-02-04 |
| 1740611375 | Rebecca Hummel-moore | Nurse Practitioner | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2013-12-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1821617168 | Michelle Nagal Hunt | Behavior Technician | 2080 Addison Street, #302, Berkeley, CA 94704 | 2020-04-15 |
| 1366097081 | Sabrina Barnett | Behavior Technician | 2080 Addison St, #302, Berkeley, CA 94704 | 2019-08-08 |
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1376014928 | Justin T Cooke | Specialist/Technologist | 2024 Durant Ave #508, Berkeley, CA 94704 | 2018-12-07 |
| 1972080158 | Cecilia Winfield | Student in an Organized Health Care Education/Training Program | 1918 University Ave., Suite 2b, Berkeley, CA 94704 | 2018-07-20 |
| 1952897332 | Jennifer Henry Henry | Naturopath | 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 | 2018-07-09 |
| 1497267967 | Merlenet Michelle Riley | Counselor | 2640 Martin Luther King, Berkeley, CA 94704 | 2017-10-24 |
| 1265951719 | Caitlin Mary Mcdonough | Student in an Organized Health Care Education/Training Program | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-09-15 |
| 1922525120 | Patrice Werling | Counselor | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-08-28 |
| Find all providers in zip 94704 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801271432 | Carina Grandison | Clinical Neuropsychologist | 2006 Dwight Way Ste 301, Berkeley, CA 94704-2633 | 2015-07-24 |
| 1104087071 | Jayne D. Hagen | Clinical Neuropsychologist | 1213 Masonic Ave, Berkeley, CA 94706 | 2008-06-23 |
| 1770620593 | Kristin Gross | Clinical Neuropsychologist | 1215 Oxford St, Berkeley, CA 94709-1422 | 2007-01-31 |
| 1598012742 | Brigid Rose | Clinical Neuropsychologist | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2012-08-07 |
| 1073771317 | Charlotte Joanne Crawford | Clinical Neuropsychologist | 3120 Telegraph Ave, Suite 2, Berkeley, CA 94705-1900 | 2008-05-22 |
| 1619198454 | Alan D. Shonkoff | Clinical Neuropsychologist | 2340 Ward St, Suite 102, Berkeley, CA 94705-1124 | 2007-05-01 |
| 1972634079 | Sonia Lifshay | Clinical Neuropsychologist | 2001 Dwight Way, 5 North, Berkeley, CA 94704-2608 | 2007-03-08 |
| 1346377280 | Leslie Ross | Clinical Neuropsychologist | 2001 Dwight Way, 5e, Berkeley, CA 94704-2608 | 2007-02-27 |
| 1528194032 | James Jeffrey Muir | Clinical Neuropsychologist | 2001 Dwight Way, Absmc Herrick, 5 North Rehabilitation, Berkeley, CA 94704-2608 | 2007-02-26 |
| 1891820510 | Michael George Weber | Clinical Neuropsychologist | 2001 Dwight Way, 5 North, Berkeley, CA 94704-2608 | 2007-02-22 |
| Find all providers in BERKELEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.