Irene Ai-Ling Wiles, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0004777 Issued in CO

Practice address

559 Vincent St
Peterson AFB, CO 80914-1541

Phone

(719) 556-4762

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Irene Yu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1609066315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-4762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3102 E. Highland Avenue",
            "address_2": "Medical Staff Office",
            "address_purpose": "LOCATION",
            "city": "Patton",
            "state": "CA",
            "postal_code": "92369",
            "country_code": "US",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILES",
        "first_name": "IRENE",
        "middle_name": "AI-LING",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24257",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENE",
            "last_name": "YU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kim Lee Vehige, LCSW
• George Allen Waddell Jr., M.D.
• Monique McWilliams Wall, LCSW
• Travis Paul Waters, PA-C
• John Franklin Watkins III, DENTIST DDS
• Jefferie Michael Wilson, MD
• June Yi, NP-C

• Clinical Psychologist in Peterson AFB, CO
• Providers in Peterson AFB, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.