Active NPI
Paul Wittenberg, PH.D.
- Psychologist
- Huntington Beach, CA
National Provider Identifier
1720127061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY5726
- Practice address
- 7212 Seaworthy Dr
Huntington Beach, CA 92648-3038 - Phone
- (714) 374-1289
- Fax
- (714) 374-5191
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- 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 | PSY5726 | CA | Primary |
Addresses
Primary practice location
7212 Seaworthy Dr
Huntington Beach, CA 92648-3038
Mailing address
7212 Seaworthy Dr
Huntington Beach, CA 92648-3038
Phone (714) 374-1289
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY057260 | Other | CA | MEDI-CAL PROVIDER NUMBER |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720127061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7212 SEAWORTHY DR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926483038",
"telephone_number": "714-374-1289",
"fax_number": "714-374-5191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7212 SEAWORTHY DR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926483038",
"telephone_number": "714-374-1289",
"fax_number": "714-374-5191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTENBERG",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY5726",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL PROVIDER NUMBER",
"identifier": "PSY057260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.