Individual provider Active NPI

Wesley William Detwiler

  • Clinical Psychologist
  • Palm Springs, CA
National Provider Identifier
1275686537
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28289 Issued in CA
Practice address
471 E Tahquitz Canyon Way
Ste 219
Palm Springs, CA 92262-6620
Phone
(619) 636-9444
NPI assigned
Jan 19, 2007
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY28289 CA Primary

Addresses

Primary practice location

471 E Tahquitz Canyon Way
Ste 219
Palm Springs, CA 92262-6620

Mailing address

471 E Tahquitz Canyon Way
Ste 219
Palm Springs, CA 92262-6620
Phone (619) 636-9444

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200214000064 CA Practitioner - Clinical Psychologist 2961838792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Detwiler Psychology ApcGroup PAC ID 0749609535, 2 clinicians

Practice addresses (Care Compare)

471 E Tahquitz Canyon Way
Suite 219
Palm Springs, CA 92262-6620
Phone (619) 636-9444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY28289CAMDClinical Psychologist
28289CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dap Health, Inc. Current Accepting new patients
Detwiler Psychology Apc Clinical CurrentSince Sep 1, 2020 Accepting new patients
Robert E Parker, PHD., a Psychological Corporation Clinical CurrentSince Sep 20, 2020 Accepting new patients

Locations

471 E Tahquitz Canyon Way
Ste 219
Palm Springs, CA 92262
Phone (619) 636-9444

Organizations & group practices 3

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1275686537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 E TAHQUITZ CANYON WAY",
            "address_2": "STE 219",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626620",
            "telephone_number": "619-636-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 E TAHQUITZ CANYON WAY",
            "address_2": "STE 219",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626620",
            "telephone_number": "619-636-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "WESLEY",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.