Travis B Wease, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY34901 Issued in CA

Practice address

444 Camino del Rio S Ste 215
San Diego, CA 92108-3510

Phone

(619) 363-5191

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Male

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

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1790530897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CAMINO DEL RIO S STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083510",
            "telephone_number": "619-363-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CAMINO DEL RIO S STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083510",
            "telephone_number": "619-363-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEASE",
        "first_name": "TRAVIS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Drew Wayson, PHD
• WCS Inc. (West Coast Speech Language Diagnostic Center)
• Hannah Nicole Weakland
• Margaret Maddox Weakley
• William Reynolds Weare
• Laura Weatherbee, LAC
• Allison Weatherford, ATC
• Dane Edward Weatherford, IDC
• Brett Erik Weatherington, DDS
• Jacob Alan Weatherly, MD

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.