Agatha Ann Wise

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

500 City Pkwy W
Orange, CA 92868-2941

Phone

(714) 916-8601

NPI assigned

Sep 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1275080129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CITY PKWY W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682941",
            "telephone_number": "714-916-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CITY PKWY W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682941",
            "telephone_number": "714-916-8601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 W Metropolitan Dr # 120",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683504",
            "country_code": "US",
            "telephone_number": "714-972-3700",
            "fax_number": "714-972-3722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "AGATHA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Irwan Lin-Wui Winson
• Anderson Winston Jr.
• Krista Winters
• Phillip Joseph Winters
• Wise Healthcare Services Inc.
• Gloria Alicia Wise
• Matthew Jay Wise, M.D.
• Patrick Wise
• Jeanne Wojslaw
• Diane Sue Wolf, M.A.CCC

• Mental Health Counselor in Orange, CA
• Providers in Orange, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.