Kathleen J Waddell, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY5636 Issued in CA

Practice address

1521 Higuera St
Ste E
San Luis Obispo, CA 93401-2958

Phone

(805) 541-8116

Fax

(805) 542-0302

NPI assigned

Sep 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285629329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 SKYLINE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051053",
            "telephone_number": "805-541-8116",
            "fax_number": "805-542-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 HIGUERA ST",
            "address_2": "STE E",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012958",
            "telephone_number": "805-541-8116",
            "fax_number": "805-542-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "KATHLEEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY5636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Claire Volpe, COTA
• Susan M Vonfrausingborch
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• Alexis Christine Vosburg, PSY.D.
• Justin E Vose
• Tina L Waggoner
• Cherish Wagner
• Cortney Paige Wagner, M.F.T.
• Rachael Mae Wahl, LVN
• Taylor Suzanne Wahl, PA-C

• Clinical Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.