Rebecca Lyn Wynsma

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4650 Sunset Blvd
Ms #53
Los Angeles, CA 90027

Phone

(323) 361-3849

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1992463020
  NPD (past)

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1104311760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD",
            "address_2": "MS #53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-361-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNSMA",
        "first_name": "REBECCA",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Kathleen McMahon Wynne, BA, MSW
• Cathleen Wynne, MA, CCC-SLP
• Heather Mee Sook Wynne, MD
• Susan Wynne, MSW, LCSW
• Walter L Wynne, M.D.
• Wyse Willa Optometry, Inc.
• Cynthia Kathryn Wyse
• Jyni C Wyse
• Danna Wysinger
• Jacek Bernard Wysocki, LMFT

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.