Paul C Wathern

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1393800620 Issued in CA

Practice address

835 25TH St
San Diego, CA 92102-2738

Phone

(619) 239-9691

Fax

(619) 239-0909

NPI assigned

Sep 7, 2020

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crash, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1124539960
  NPD (past)

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1487268462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 CEDAR ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021599",
            "telephone_number": "619-301-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022738",
            "telephone_number": "619-239-9691",
            "fax_number": "619-239-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATHERN",
        "first_name": "PAUL",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-07",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R139800620",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1393800620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn A Waters, RN
• Katherine Lorraine Waters, PT, DPT
• Valerie Waters, NP-C
• Jessica Karas Waterson, L.M.F.T
• Carmelita Wathen
• Julie Watkins-Torry, M.D.
• Alexis L Watkins
• Alison Watkins, APCC
• Brianna Watkins
• Ebony Nicole Watkins

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.