Active NPI
Wakiza Gamez, PH.D.
- Clinical Psychologist
- Iowa City, IA
National Provider Identifier
1740639897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001143
- Practice address
- 1703 Rochester CT
Iowa City, IA 52245-3241 - Phone
- (319) 333-8963
- NPI assigned
- Jun 9, 2016
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001143 | IA | Primary |
Addresses
Primary practice location
1703 Rochester CT
Iowa City, IA 52245-3241
Mailing address
PO Box 1670
Iowa City, IA 52244-1670
Phone (319) 333-8963
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231117001722 | TX | Practitioner - Clinical Psychologist | 8022465715 | Practice locations: Austin, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39492 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1740639897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1670",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522441670",
"telephone_number": "319-333-8963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 ROCHESTER CT",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522453241",
"telephone_number": "319-333-8963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMEZ",
"first_name": "WAKIZA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-09",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IA",
"license": "001143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.