Individual provider Active NPI

Dianne P Wheeler-Callin, PHD

  • Clinical Psychologist
  • Hemet, CA
National Provider Identifier
1720004500
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9169 Issued in CA
Practice address
3292 E Florida Ave
Suite C
Hemet, CA 92544-4941
Phone
(951) 766-4690
Fax
(951) 766-4691
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9169 CA Primary

Addresses

Primary practice location

3292 E Florida Ave
Suite C
Hemet, CA 92544-4941

Mailing address

3292 E Florida Ave
Suite C
Hemet, CA 92544-4941
Phone (951) 766-4690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090529000136 CA Practitioner - Clinical Psychologist 9638228307 Practice locations: Hemet, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

41555 State Hwy 74
Suite a
Hemet, CA 92544-4995
Phone (951) 766-4690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9169CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1720004500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3292 E FLORIDA AVE",
            "address_2": "SUITE C",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925444941",
            "telephone_number": "951-766-4690",
            "fax_number": "951-766-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 E FLORIDA AVE",
            "address_2": "SUITE C",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925444941",
            "telephone_number": "951-766-4690",
            "fax_number": "951-766-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER-CALLIN",
        "first_name": "DIANNE",
        "middle_name": "P",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.