Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1326194911 Individual Practitioner Male Practitioner

John Anthony Dedomenico , MS MFT

Counselor - Professional • Berkeley, CA

Professional Overview & Biography Verified Profile Summary

John Dedomenico, MS MFT is a registered healthcare professional specializing in Counselor - Professional in Berkeley, CA. Practice services are available at 2020 BLAKE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2020 Blake St

Berkeley, CA 94704

Telephone 4157461967

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Berkeley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.5 Yrs
State Avg: 10.8 Yrs
Regional Practice Density
27 Specialists

Practicing in Berkeley, CA (4040 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CA MFC 30336

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bis
30097 (CA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
NPI 1154630135
NPI 1326373929
Stephen Zubach , MS

Marriage & Family Therapist

NPI 1336372606

Master of Science

Leticia Manzanares , CAADE INTERN

Counselor - Addiction (Substance Use Disorder)

NPI 1548307739

CAADEINTERN

Diane Policelli , LMFT CATC

Marriage & Family Therapist

NPI 1649504580

LMFTCATC

Nicole Bookman , MFTI

Marriage & Family Therapist

NPI 1881924215

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2020 BLAKE ST, BERKELEY, CA 94704 (Tel: 4157461967)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2020 BLAKE ST, BERKELEY, CA 947042604 (Tel: 5108482444)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN DEDOMENICO, M.S. MFT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #MFC 30336 in CA)

🟢
Initial NPI Registration & Enumeration January 26, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1326194911
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 26, 2007
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

2020 Blake St

Berkeley, CA 947042604

Phone: 5108482444

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.