Laura Davidoff Wiedeman, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY26875 Issued in CA

Practice address

1303 Jefferson St Ste 600a
Napa, CA 94559-2473

Phone

(707) 203-2447

NPI assigned

Jan 9, 2014

Last updated

Dec 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1346662418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 JEFFERSON ST STE 600A",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592473",
            "telephone_number": "707-203-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 JEFFERSON ST STE 600A",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592473",
            "telephone_number": "707-203-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMAN",
        "first_name": "LAURA",
        "middle_name": "DAVIDOFF",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008744",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Whiteside
• Cameron Whitfield
• Tammy Lynn Whitt, CATC
• Whole Health Weight Loss Institute
• Merry D Widmeyer, PA
• Stephen J. Wieder, MD
• Mary Wiggs
• Beatrice Wigington, REGISTERED NURSE
• Rhonda Wikstrom, LVN
• Alanna Wiley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.