Individual provider Active NPI

Carl Steed Wells

  • Psychologist
  • Huntington Beach, CA
National Provider Identifier
1821122516
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY13062 Issued in CA
Practice address
16168 Beach Blvd Ste 241
Huntington Beach, CA 92647-3890
Phone
(714) 960-2490
NPI assigned
Mar 15, 2007
Last updated
Feb 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY13062 CA Primary

Addresses

Primary practice location

16168 Beach Blvd Ste 241
Huntington Beach, CA 92647-3890

Mailing address

16168 Beach Blvd
241
Huntington Beach, CA 92647-3816
Phone (714) 960-2490

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070809000399 CA Practitioner - Clinical Psychologist 0941391601 Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16168 Beach Blvd
Suite 241
Huntington Beach, CA 92647-3890
Phone (714) 960-2490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13062CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1821122516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16168 BEACH BLVD",
            "address_2": "241",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473816",
            "telephone_number": "714-960-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16168 BEACH BLVD STE 241",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473890",
            "telephone_number": "714-960-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CARL",
        "middle_name": "STEED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY13062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.