Kerry Ellen Wangen, MD, PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A96499 Issued in CA

Practice address

101 The City Dr S BLDG 3
Department of Psychiatry
Orange, CA 92868-3201

Phone

(714) 456-5770

NPI assigned

Mar 24, 2007

Last updated

Mar 19, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1841317609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S BLDG 3",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S BLDG 3",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGEN",
        "first_name": "KERRY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A96499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winston Wang, L.AC
• Yanfeng Wang, M.D.
• Yingxue Wang
• Yujie Wang, CMT
• Zhan Tao Wang, M.D.
• Gerry Mary Waniewski, PSY.D.
• Emily Marie Ward, NURSE PRACTITIONER
• Garrett Graham Ward, M.D.
• Hannah Ward, DO
• Nikki Ward

• Psychiatry Physician in Orange, CA
• Providers in Orange, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.