Active NPI
Jessica N Wieland, LPCC
- Professional Counselor
- Stockton, CA
National Provider Identifier
1164751392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 173
- Practice address
- 1212 N California St
Stockton, CA 95202 - Phone
- (209) 468-8786
- NPI assigned
- Dec 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 173 | CA | Primary |
Addresses
Primary practice location
1212 N California St
Stockton, CA 95202
Mailing address
3601 Pacific Ave
University of the Pacific- Psychology Dept - CRP
Stockton, CA 95211-0110
Phone (209) 464-5519
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 173 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1164751392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 PACIFIC AVE",
"address_2": "UNIVERSITY OF THE PACIFIC- PSYCHOLOGY DEPT - CRP",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952110110",
"telephone_number": "209-464-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "95202",
"telephone_number": "209-468-8786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIELAND",
"first_name": "JESSICA",
"middle_name": "N",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-17",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.