Individual provider Active NPI

Haiyan Wang, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1376979849
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A138796 Issued in CA
Practice address
5140 W Goldleaf Cir Ste 250
Los Angeles, CA 90056-1299
Phone
(866) 442-1382
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A138796 CA
Psychiatry Physician 2084P0800X A138796 CA Primary

Addresses

Primary practice location

5140 W Goldleaf Cir Ste 250
Los Angeles, CA 90056-1299

Mailing address

34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411

Other practice location 1

1 Park Ave
Child and Aldolescent Psychiatry
New York, NY 10016-5802
Phone (646) 754-5079

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 Medicine

State licenses

LicenseStateTypeSpecialty
A138796CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Mental Health Service Psychiatry Current Accepting new patients
Rogers Behavioral Health, Inc. CurrentSince Dec 15, 2019 Accepting new patients
Neuro Wellness Spa, a Medical PC Psychiatry Past Accepting new patients
Rogers Behavioral Health, Inc. PastSince Dec 15, 2019 Accepting new patients

Locations

5140 W Goldleaf Cir
Ste 250
Los Angeles, CA 90056
Phone (262) 563-9755

34700 Valley Rd
Oconomowoc, WI 53066

Organizations & group practices 4

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1376979849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 W GOLDLEAF CIR STE 250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561299",
            "telephone_number": "866-442-1382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Park Ave",
            "address_2": "Child and Aldolescent Psychiatry",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100165802",
            "country_code": "US",
            "telephone_number": "646-754-5079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "HAIYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A138796",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A138796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.