Active NPI
Amy Wytiaz, PH.D.
- Psychologist
- Dublin, CA
National Provider Identifier
1689962813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 29962
- Practice address
- 4633 Newhaven St
Dublin, CA 94568-7661 - Phone
- (510) 579-0311
- NPI assigned
- Jul 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 29962 | CA | Primary |
Addresses
Primary practice location
4633 Newhaven St
Dublin, CA 94568-7661
Mailing address
4633 Newhaven St
Dublin, CA 94568-7661
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29962 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1689962813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4633 NEWHAVEN ST",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945687661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4633 NEWHAVEN ST",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945687661",
"telephone_number": "510-579-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYTIAZ",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-21",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "29962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.