Active NPI
Marquis Philip Vawter, PHD, MSED
- Psychologist
- Orange, CA
National Provider Identifier
1184150559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 16694
- Practice address
- 101 City Drive
University of California Irvine Medical Center
Orange, CA 92868 - Phone
- (949) 824-9014
- NPI assigned
- May 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 16694 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | MFC 25914 | CA |
Addresses
Primary practice location
101 City Drive
University of California Irvine Medical Center
Orange, CA 92868
Mailing address
28361 Via Alfonse
Laguna Niguel, CA 92677-7060
Phone (949) 824-9014
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 16694 | CA | MD | Psychologist |
| MFC 25914 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1184150559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28361 VIA ALFONSE",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926777060",
"telephone_number": "949-824-9014",
"fax_number": "949-824-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CITY DRIVE",
"address_2": "UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER",
"city": "ORANGE",
"state": "CA",
"postal_code": "92868",
"telephone_number": "949-824-9014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAWTER",
"first_name": "MARQUIS",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "PHD, MSED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-04",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 16694",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 25914",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.