Individual provider Active NPI

Alice R. Wiedenhoff, PHD

  • Intellectual & Developmental Disabilities Psychologist
  • Carlsbad, CA
National Provider Identifier
1053524082
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
North County Child Study Center, 6949 El Camino Real
Ste. 201
Carlsbad, CA 92009-4140
Phone
(769) 603-7770
Fax
(760) 603-7753
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 17454 CA
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

North County Child Study Center, 6949 El Camino Real
Ste. 201
Carlsbad, CA 92009-4140

Mailing address

North County Child Study Center, 6949 El Camino Real
Ste. 201
Carlsbad, CA 92009-4140
Phone (769) 603-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
17454CAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053524082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH COUNTY CHILD STUDY CENTER, 6949 EL CAMINO REAL",
            "address_2": "STE. 201",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920094140",
            "telephone_number": "769-603-7770",
            "fax_number": "760-603-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTH COUNTY CHILD STUDY CENTER, 6949 EL CAMINO REAL",
            "address_2": "STE. 201",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920094140",
            "telephone_number": "769-603-7770",
            "fax_number": "760-603-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDENHOFF",
        "first_name": "ALICE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "17454",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.