Michael Wydo, PSY.D., ABPP

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

20171 Issued in CA

Practice address

5092 Flamingo Cir
Huntington Beach, CA 92649-1408

Phone

(919) 521-1835

NPI assigned

Mar 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 10, 2018 through Dec 10, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DBT California

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1689100521
  NPD (past)

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1104287325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5092 FLAMINGO CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491408",
            "telephone_number": "919-521-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5092 FLAMINGO CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491408",
            "telephone_number": "919-521-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYDO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D., ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "20171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Lawrence Wright, DDS
• Craig Joseph Wronski, DO
• Chunta Wu
• Cindy Y Wu
• Sidney S Wu, M.D.
• Stephen Marc Wyman, M.D.
• Ryan Wyn, D.D.S.
• Patricia Wynne, MA LMFT
• Caroline Xanthakis
• Pedro Xuncax

• Cognitive & Behavioral Psychologist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.