Individual provider Active NPI

William Robert Wendelaar III

  • Professional Counselor
  • Sacramento, CA
National Provider Identifier
1659958676
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
3650 Auburn Blvd # C-208
Sacramento, CA 95821-2069
Phone
(916) 300-6576
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

3650 Auburn Blvd # C-208
Sacramento, CA 95821-2069

Mailing address

2496 Shirland Tract Rd
Auburn, CA 95603-7712
Phone (619) 867-6149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Practice Counseling Group PastSince Mar 28, 2021 Accepting new patients

Organizations & group practices 1

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1659958676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 SHIRLAND TRACT RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956037712",
            "telephone_number": "619-867-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 AUBURN BLVD # C-208",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212069",
            "telephone_number": "916-300-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELAAR",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.