Individual provider Active NPI

E. Warren O'Meara, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1124185947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8654 Issued in CA
Practice address
10755 Scripps Poway Pkwy Ste F
Suite 111
San Diego, CA 92131-3924
Phone
(858) 566-0123
Fax
(858) 566-0050
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY8654 CA Primary

Addresses

Primary practice location

10755 Scripps Poway Pkwy Ste F
Suite 111
San Diego, CA 92131-3924

Mailing address

10755 Scripps Poway Pkwy Ste F
Suite 111
San Diego, CA 92131-3924
Phone (858) 566-0123

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
PSY8654CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124185947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10755 SCRIPPS POWAY PKWY STE F",
            "address_2": "SUITE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313924",
            "telephone_number": "858-566-0123",
            "fax_number": "858-566-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 SCRIPPS POWAY PKWY STE F",
            "address_2": "SUITE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313924",
            "telephone_number": "858-566-0123",
            "fax_number": "858-566-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MEARA",
        "first_name": "E.",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.