Active NPI
James A Wakefield Jr., PH.D.
- Clinical Psychologist
- Incline Village, NV
National Provider Identifier
1831659077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY11298
- Practice address
- 696 Village Blvd Unit 27
Incline Village, NV 89451-9098 - Phone
- (209) 769-9409
- Fax
- (775) 298-7322
- NPI assigned
- Mar 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY11298 | CA | Primary |
Addresses
Primary practice location
696 Village Blvd Unit 27
Incline Village, NV 89451-9098
Mailing address
PO Box 5754
Incline Village, NV 89450-5754
Phone (209) 769-9409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11298 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553212800000",
"number": "1831659077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5754",
"city": "INCLINE VILLAGE",
"state": "NV",
"postal_code": "894505754",
"telephone_number": "209-769-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "696 VILLAGE BLVD UNIT 27",
"city": "INCLINE VILLAGE",
"state": "NV",
"postal_code": "894519098",
"telephone_number": "209-769-9409",
"fax_number": "775-298-7322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "JAMES",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-22",
"last_updated": "2019-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY11298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Incline Village, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.