Gordon Moor Wheeler, PHD

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

License

6509 Issued in MA

Practice address

302 Moore St
Santa Cruz, CA 95060-2516

Phone

(831) 917-1676

NPI assigned

Jun 23, 2018

Last updated

Jun 23, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529712000000",
    "number": "1639664576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MOORE ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602516",
            "telephone_number": "831-917-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MOORE ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602516",
            "telephone_number": "831-917-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "GORDON",
        "middle_name": "MOOR",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-23",
        "last_updated": "2018-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "6509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICD PSYCHOLOGIST PROVIDER",
            "identifier": "6509",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICD PSYCHOLOGY PROVIDER",
            "identifier": "6509",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Westra, NP
• Allan Wetzel, DPT
• Tamar Wexler
• Patricia G. Weyland, MS, APRN, BC, FNP
• Bradley Dale Whaley, M.D.
• Karen Whippy
• Leo Scott Whisten
• Haley Jane Whiston, MA
• Catherine White
• Gregory Lewis White, PHD

• Adult Development & Aging Psychologist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Adult Development & Aging Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2018; 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.