BONNIE KAHANE (PHD) – Clinical Psychologist, NPI 1104963255

BONNIE KAHANE (PHD) is a healthcare provider. based in Berkeley, California. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PSY12953 (CA). The NPI Number for BONNIE KAHANE (PHD) is 1104963255

Main info

Female
36 Years Of Experience
Name
BONNIE KAHANE (PHD)
NPI
1104963255
Phone
(510) 841-8484
Address
1749 MARTIN LUTHER KING JR WAY
Enumeration Date
30 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
51084184841130
Graduation Year
1990 (36 years ago)
PAC ID
1759443682
Group Practice PAC ID
2264414283
Professional Enrollment ID
I20081230000604
Address ID
CA947092139BE1749XWAYX600
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,473 CLINICAL PSYCHOLOGIST in CA

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Provider Addresses for BONNIE KAHANE (PHD)

  • 1749, Martin Luther King Junior Way, North Berkeley, Berkeley, Alameda County, California, 94709, United States

    BERKELEY, CA 947092139

    Phone: (510) 841-8484

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-12-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081230000604IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94709)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264414283View full group profile
NameSpecialtyState
Clinical PsychologistCA
Clinical PsychologistCA
Clinical PsychologistCA
P S Y C H I A T R YCA
Clinical PsychologistCA
-CA
Clinical PsychologistCA
-CA
P S Y C H I A T R YCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Is BONNIE KAHANE (PHD) listed with a National Provider Identifier?
Yes — BONNIE KAHANE (PHD) has NPI 1104963255 on file in the registry.
Is there an active status for BONNIE KAHANE (PHD)?
For scheduling context, BONNIE KAHANE (PHD) is shown as active in the registry.
What kind of doctor is BONNIE KAHANE (PHD)?
BONNIE KAHANE (PHD) is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Is BONNIE KAHANE (PHD) associated with Berkeley?
Public fields place BONNIE KAHANE (PHD) around Berkeley, California. Always confirm the exact site before visiting.
Can I trust this NPI listing for BONNIE KAHANE (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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