Thomas Allen Wickham, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY6128 Issued in CA

Practice address

1210 Nevada St
Suite101
Redlands, CA 92374-2895

Phone

(909) 793-8312

Fax

(909) 792-6507

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Other names 1

• Thomas A Wickham Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Redlands Psychological, Inc.

  • Clinical Psychologist
  • Redlands, CA
  • NPI 1770625212
  NPD (past) Authorized official
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1609918663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 NEVADA ST",
            "address_2": "SUITE101",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742895",
            "telephone_number": "909-793-8312",
            "fax_number": "909-792-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEVADA ST",
            "address_2": "SUITE101",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742895",
            "telephone_number": "909-793-8312",
            "fax_number": "909-792-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "THOMAS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6128",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY6128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "WICKHAM",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hannah Jimmy Whitener
• Steve Whiting
• Rudi Lajean Whitmore, LPCC
• Florence Vincent Whyte, NP
• Rosalie Whyte
• Margaret Elizabeth Wilcox
• Brent Wild, DPT
• James Robert Wiley, PA-C
• Jacqueline Michelle Williams Reade, MS, PHD, LMFT, LCPC
• David Williams

• Clinical Psychologist in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.