PL Wiz Psychology Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY6796 Issued in CA

Legal business name

PL WIZ PSYCHOLOGY INC

Practice address

1427 21St St Apt a
Santa Monica, CA 90404-2970

Phone

(310) 828-1332

Fax

(310) 587-9206

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Patricia L Wisne, PH.D.

Title

Owner

Phone

(310) 828-1332

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1790929495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 21ST ST APT A",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042970",
            "telephone_number": "310-828-1332",
            "fax_number": "310-587-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 21ST ST APT A",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042970",
            "telephone_number": "310-828-1332",
            "fax_number": "310-587-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PL WIZ PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "WISNE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-828-1332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY6796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Santa Monica, CA
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• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.