Active NPI
Jamie Lou Wayne
- Professional Counselor
- San Diego, CA
National Provider Identifier
1508456849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6186
- Practice address
- 5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193 - Phone
- (858) 859-8861
- NPI assigned
- Jan 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6186 | CA | Primary |
Addresses
Primary practice location
5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193
Mailing address
2150 Comstock St Unit 712753
San Diego, CA 92171-7112
Other practice location 1
1000 G St Ste 125
Sacramento, CA 95814-0894
Phone (888) 588-8995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6186 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1508456849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 COMSTOCK ST UNIT 712753",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921717112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR STE 309",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205193",
"telephone_number": "858-859-8861"
}
],
"practiceLocations": [
{
"address_1": "1000 G St Ste 125",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958140894",
"country_code": "US",
"telephone_number": "888-588-8995",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAYNE",
"first_name": "JAMIE",
"middle_name": "LOU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-20",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "6186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.