Jaycie Wildermuth

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

141816 Issued in CA

Practice address

4250 Fowler LN Ste 204
Diamond Springs, CA 95619-9782

Phone

(530) 295-1491

NPI assigned

Aug 15, 2022

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Rene Nevarez Licensed Marriage Family Therapist and Clinical Counselor Inc

  • Mental Health Counselor
  • Sacramento, CA
  • NPI 1972174274
  NPD
• Turning Point Community Programs

  dba CORE Madison

  • Community/Behavioral Health Agency
  • North Highlands, CA
  • NPI 1417580093
  NPD (past)

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1215665427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956910112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LN STE 204",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199782",
            "telephone_number": "530-295-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8950 Cal Center Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958263247",
            "country_code": "US",
            "telephone_number": "916-707-1758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDERMUTH",
        "first_name": "JAYCIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2024-02-01",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "14738",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141816",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Joanne Walsh, MA
• Christina Walters
• Phyllis Njeri Wanjeru
• Noelle Warman
• Amber Dawn Westbrook
• Dindy Dehli Williams
• Gerrie Deshon Williams
• Kimberly Wilson, LMFT
• Wise Mind Solutions, Inc
• Lisa Wollard

• Marriage & Family Therapist in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.