Individual provider Active NPI

Jonathan David Seiberlich-Wheeler, MA

  • Psychologist
  • Santa Rosa, CA
National Provider Identifier
1750863544
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSB94024126 Issued in CA
Practice address
534 B St
Santa Rosa, CA 95401-5211
Phone
(707) 579-0465
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSB94024126 CA Primary

Addresses

Primary practice location

534 B St
Santa Rosa, CA 95401-5211

Mailing address

PO Box 2943
Rohnert Park, CA 94927-2943

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
I20250310003238 CA Practitioner - Clinical Psychologist 0749701472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PSB94024126CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychologist CurrentSince Feb 7, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1750863544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2943",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949272943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 B ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015211",
            "telephone_number": "707-579-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBERLICH-WHEELER",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94024126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.