Individual provider Active NPI

Ann Whealen Pockros, PH.D.

  • Clinical Psychologist
  • La Jolla, CA
National Provider Identifier
1336242809
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12732 Issued in CA
Practice address
4180 La Jolla Village Dr
Suite 530
La Jolla, CA 92037-1402
Phone
(858) 552-1005
NPI assigned
Sep 7, 2006
Last updated
Sep 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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 PSY12732 CA Primary

Addresses

Primary practice location

4180 La Jolla Village Dr
Suite 530
La Jolla, CA 92037-1402

Mailing address

PO Box 9905
Rancho Santa Fe, CA 92067-4905
Phone (858) 552-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1336242809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9905",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920674905",
            "telephone_number": "858-552-1005",
            "fax_number": "858-756-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 LA JOLLA VILLAGE DR",
            "address_2": "SUITE 530",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371402",
            "telephone_number": "858-552-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCKROS",
        "first_name": "ANN",
        "middle_name": "WHEALEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.