Individual provider Active NPI

Terry Charles Weyl, PH.D.

  • Psychologist
  • Placerville, CA
National Provider Identifier
1376702415
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY6138 Issued in CA
Practice address
941 Spring St Ste 5
Placerville, CA 95667-4546
Phone
(530) 341-8772
Fax
(530) 698-5241
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY6138 CA Primary

Addresses

Primary practice location

941 Spring St Ste 5
Placerville, CA 95667-4546

Mailing address

941 Spring St Ste 5
Placerville, CA 95667-4546
Phone (530) 341-8772

Other practice location 1

5832 Shelldrake Ct
Fair Oaks, CA 95628-2728
Phone (916) 716-8262

Other identifiers 1

IdentifierTypeStateIssuer
PSY061380MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
PSY6138CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Park Counseling Center, Inc. CurrentSince Jul 29, 2012 Accepting new patients
Professional Services Associates a Professional Psychological Corporat Psychologist CurrentSince Jul 24, 2022 Accepting new patients
Cameron Park Counseling Center PastSince Jul 29, 2012 Accepting new patients

Locations

3330 Heights Dr
Ste 120
Cameron Park, CA 95682
Phone (530) 677-4404

941 Spring St
Ste 5
Placerville, CA 95667
Phone (530) 341-8772

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376702415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 SPRING ST STE 5",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674546",
            "telephone_number": "530-341-8772",
            "fax_number": "530-698-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 SPRING ST STE 5",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674546",
            "telephone_number": "530-341-8772",
            "fax_number": "530-698-5241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5832 Shelldrake Ct",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956282728",
            "country_code": "US",
            "telephone_number": "916-716-8262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYL",
        "first_name": "TERRY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY6138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY061380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.