Kelly P Wildowsky

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

110520 Issued in CA

Practice address

101 S B St
Lompoc, CA 93436-6933

Phone

(805) 667-7486

NPI assigned

Jul 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Service Agency of Santa Barbara County

  • Adult Mental Health Clinic/Center
  • Santa Barbara, CA
  • NPI 1407877566
  Medicare reassignment NPD

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1750933735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S B ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366933",
            "telephone_number": "805-667-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S B ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366933",
            "telephone_number": "805-667-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDOWSKY",
        "first_name": "KELLY",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea L Werner, MS CCC SLP
• Sarah E Wesoff, MASTERS DEGREE
• Cierra West, BS
• Whitney Nicole White, FNP
• Michelle Gabrielle Wiant
• Sidney John Wiley, O.D.
• Wilkerson Chiropractic, Inc.
• Marc F. Wilkerson, DC
• John Benjamin Wilkinson, M.D.
• Mary J Willems, RN

• Marriage & Family Therapist in Lompoc, CA
• Providers in Lompoc, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.