Stacy M Wadlington PH.D.Liscense Psychologist P.C.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PSY20509 Issued in CA

Legal business name

STACY M WADLINGTON PH.D.LISCENSE PSYCHOLOGIST P.C.

Practice address

595 E Colorado Blvd
Suite 529
Pasadena, CA 91101-2039

Phone

(323) 692-7775

Fax

(626) 793-7553

NPI assigned

May 15, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Stacy Monique Wadlington, PH.D

Title

Owner/President

Phone

(323) 497-2557

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1225474349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD",
            "address_2": "SUITE 529",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD",
            "address_2": "SUITE 529",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012039",
            "telephone_number": "323-692-7775",
            "fax_number": "626-793-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY M WADLINGTON PH.D.LISCENSE PSYCHOLOGIST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "WADLINGTON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "323-497-2557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "PSY20509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.