Paul G. Wertzberger, LCSW., PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27351 Issued in CA

Practice address

1005 Ream Ave
Mount Shasta, CA 96067-2539

Phone

(831) 586-0065

NPI assigned

Sep 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1346599289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 REAM AVE",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672539",
            "telephone_number": "831-586-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 REAM AVE",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672539",
            "telephone_number": "831-586-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTZBERGER",
        "first_name": "PAUL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "LCSW., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY27351",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13493",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Elaine Wadman, M.D.
• Sibyl Jean Walski
• Elliott Pierce Wayburn-Best, LVN
• Denese Gail Welch, RDH, RDHAP
• Nathan Welker
• Western Physical Therapy, Inc.
• Marianne Wilson
• Alyssa Winkelman
• Carol Winston, PT
• Susan Wolcott, LM, CPM, RN

• Clinical Psychologist in Mount Shasta, CA
• Providers in Mount Shasta, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.