Individual provider Active NPI

Virginia Leigh Watford, PHD

  • Clinical Psychologist
  • Mission Viejo, CA
National Provider Identifier
1740391069
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 5281 Issued in CA
Practice address
27405 Puerta Real
Suite 150
Mission Viejo, CA 92691-6314
Phone
(949) 348-2850
Fax
(949) 348-2850
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 5281 CA Primary

Addresses

Primary practice location

27405 Puerta Real
Suite 150
Mission Viejo, CA 92691-6314

Mailing address

1530 Santa Cruz Street
Laguna Beach, CA 92651-3318
Phone (949) 494-6823

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
I20110302000113 CA Practitioner - Clinical Psychologist 5294916839 Practice locations: Mission Viejo, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

27405 Puerta Real
Suite 150
Mission Viejo, CA 92691-6366
Phone (949) 348-2850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 5281CAMDClinical Psychologist
5281CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740391069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SANTA CRUZ STREET",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926513318",
            "telephone_number": "949-494-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27405 PUERTA REAL",
            "address_2": "SUITE 150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916314",
            "telephone_number": "949-348-2850",
            "fax_number": "949-348-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATFORD",
        "first_name": "VIRGINIA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 5281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.