Joanne J. Wendt, PH.D., Clinical Psychologist, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY15145 Issued in CA

Legal business name

JOANNE J. WENDT, PH.D., CLINICAL PSYCHOLOGIST, INC.

Practice address

12535 Camino Emparrado
San Diego, CA 92128-1401

Phone

(858) 674-4913

NPI assigned

Nov 26, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Joanne Jean Wendt, PH.D.

Title

Ceo/Owner

Phone

(858) 674-4913

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1132963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215910989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12535 CAMINO EMPARRADO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921281401",
            "telephone_number": "858-674-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12535 CAMINO EMPARRADO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921281401",
            "telephone_number": "858-674-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE J. WENDT, PH.D., CLINICAL PSYCHOLOGIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WENDT",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "858-674-4913",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "OPL151450",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "184757",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY151450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.