Organization Active NPI

Gwen Obryan PHD LTD

  • Clinical Psychologist
  • Reno, NV
National Provider Identifier
1811007792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GWEN OBRYAN PHD LTD
Practice address
325 Flint Street
Reno, NV 89501
Phone
(775) 329-3339
Fax
(775) 329-9935
NPI assigned
Aug 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gwen Obryan, PHD
Title
President
Phone
(775) 329-3339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

325 Flint Street
Reno, NV 89501

Mailing address

325 Flint Street
Reno, NV 89501
Phone (775) 329-3339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701001429 NV Part B Supplier - Clinic/Group Practice 7911984471 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

325 Flint St
Reno, NV 89501
Phone (775) 329-3339

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811007792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 FLINT STREET",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89501",
            "telephone_number": "775-329-3339",
            "fax_number": "775-329-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 FLINT STREET",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89501",
            "telephone_number": "775-329-3339",
            "fax_number": "775-329-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWEN OBRYAN PHD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OBRYAN",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-329-3339",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.