Ian Michael Wanamaker

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

149344 Issued in CA

Practice address

1105 E Florida Ave
Hemet, CA 92543-4512

Phone

(951) 439-2945

NPI assigned

Jul 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1780202242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 E FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434512",
            "telephone_number": "951-439-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 E FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434512",
            "telephone_number": "951-439-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANAMAKER",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-10",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sharon Denise Wang, NP
• Shirley Lee Wang, M.D.
• Felecia La-an Ward
• Gerald D Wareham, M.D.

• Marriage & Family Therapist in Hemet, CA
• Providers in Hemet, 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 Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.