Individual provider Active NPI

Elizabeth Sears-Wiley, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1215394382
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95007257 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(858) 534-7792
NPI assigned
Jan 20, 2016
Last updated
Jan 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95007257 CA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 782325 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other names 1

  • Elizabeth Sears Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180206001454 CA Practitioner - Nurse Practitioner 0648530949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Systems IncGroup PAC ID 8628019320, 37 clinicians

Practice addresses (Care Compare)

474 W Vermont Ave
Suite 104
Escondido, CA 92025-6584
Phone (760) 432-9884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo, Inc CurrentSince Jun 9, 2018 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Regents of the University of California CurrentSince Dec 9, 2017 Accepting new patients
Regents of the University of California CurrentSince Dec 9, 2017 Accepting new patients
Mental Health Systems, Inc. CurrentSince Sep 23, 2021 Accepting new patients
Mental Health Systems, Inc. Current Accepting new patients
Community Research Foundation Inc CurrentSince Aug 15, 2018 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Jun 9, 2018 Accepting new patients

Locations

321 W Hobsonway
Ste C
Blythe, CA 92225
Phone (760) 922-4981

474 W Vermont Ave
Ste 104
Escondido, CA 92025
Phone (760) 270-9068

File 57326
Los Angeles, CA 90074

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

Interoperability endpoints

  • Direct secure messaging: elizabeth.wileysears.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1215394382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "858-534-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS-WILEY",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95007257",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "782325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SEARS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.