Individual provider Active NPI

Roger Wunderlich, MD

  • Forensic Psychiatry Physician
  • Atascadero, CA
National Provider Identifier
1558313791
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
G41736 Issued in CA
Practice address
10333 El Camino Real
Atascadero, CA 93423-7001
Phone
(805) 468-2000
Fax
(805) 466-6011
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X G41736 CA Primary

Addresses

Primary practice location

10333 El Camino Real
Atascadero, CA 93423-7001

Mailing address

1600 9TH Street
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090303000197 CA Practitioner - Psychiatry 1557427333 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41736CAMDMarriage & Family Therapist
G41736CAMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Nov 23, 2015 Accepting new patients
Department of State Hospitals Current Accepting new patients
State of California - Department of Developmental Services Past Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558313791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934237001",
            "telephone_number": "805-468-2000",
            "fax_number": "805-466-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "G41736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.