Individual provider Active NPI

Wendy McCray, PH.D.

  • Psychologist
  • Elk Grove, CA
National Provider Identifier
1508119934
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 15856 Issued in CA
Practice address
3125 Dwight Rd
Suite 200
Elk Grove, CA 95758-6477
Phone
(530) 218-5836
Fax
(530) 758-8578
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 15856 CA Primary

Addresses

Primary practice location

3125 Dwight Rd
Suite 200
Elk Grove, CA 95758-6477

Mailing address

3125 Dwight Rd
Suite 200
Elk Grove, CA 95758-6477
Phone (530) 218-5836

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
PSY 15856CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Darrell Broaddus Psychological Services PC PastSince Mar 10, 2018 Accepting new patients

Organizations & group practices 1

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": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1508119934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DWIGHT RD",
            "address_2": "SUITE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586477",
            "telephone_number": "530-218-5836",
            "fax_number": "530-758-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 DWIGHT RD",
            "address_2": "SUITE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586477",
            "telephone_number": "530-218-5836",
            "fax_number": "530-758-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAY",
        "first_name": "WENDY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 15856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.