Kimberly Loraine Wells, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY27907 Issued in CA

Practice address

300 Prison Rd
Represa, CA 95671-3001

Phone

(916) 985-8610

NPI assigned

Jan 4, 2013

Last updated

May 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Coast Psychology Group IncGroup PAC ID 9335410729, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Coast Psychology Group, Inc.

  • Psychologist
  • Westlake Village, CA
  • NPI 1932647468
  Medicare reassignment Care Compare group NPD
• HLN Physicians Inc

  • Psychiatry Physician
  • Gold River, CA
  • NPI 1073899191
  Medicare reassignment NPD
• Uhs BH Telepsych FL, PLLC

  • Psychiatry Physician
  • Ponte Vedra Beach, FL
  • NPI 1790453033
  NPD (past)

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1588901938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221611",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958228611",
            "telephone_number": "619-244-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PRISON RD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956713001",
            "telephone_number": "916-985-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9272 Laguna Springs Dr",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957587947",
            "country_code": "US",
            "telephone_number": "916-582-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KIMBERLY",
        "middle_name": "LORAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY27907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Lee Vanderostyne, L.C.S.W.
• Sheena Varghese, RPH
• Michael Bernard Vasquez
• Heather Waddle
• Violka Wanie
• Tracy Michelle Weyer, PSY.D.
• R. David Wheeler, PSYD
• James Joseph Whelan Jr., PH.D.
• Regina White
• Halie Williams, PSYD

• Psychologist in Represa, CA
• Providers in Represa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.