Owens Valley Wellness

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27059 Issued in CA

Legal business name

OWENS VALLEY WELLNESS

Practice address

686 W Line St
Bishop, CA 93514-3315

Phone

(760) 920-6210

NPI assigned

Jan 28, 2016

Last updated

Jan 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacob Eide, PSY.D.

Title

Clinical Psychologist/Owner

Phone

(760) 920-6210

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1295193720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 W LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143315",
            "telephone_number": "760-920-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 W LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143315",
            "telephone_number": "760-920-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENS VALLEY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "EIDE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "760-920-6210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jean Orlowski, DPT
• Teresa Michelle Oser
• Katrina Lynne Otten, RD
• Gabriel Overholtzer, D.D.S.
• Owens Valley Acupuncture, Inc
• Christina M. Palomo
• Ashvin C Pandya, M.D.
• Manish Pandya, M.D.
• Katharine Paquette
• Sue Jin Park, RN

• Clinical Psychologist in Bishop, CA
• Providers in Bishop, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.