Garrett L. Watanabe, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A74445 Issued in CA

Practice address

20380 Town Center LN
Suite 215
Cupertino, CA 95014-3210

Phone

(408) 996-7950

Fax

(408) 996-7997

NPI assigned

Oct 27, 2006

Last updated

Jul 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: garrett.watanabe@157411.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Area Clinical Associates, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1801370853

  Child & Adolescent Psychiatry

  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1851477376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20380 TOWN CENTER LN",
            "address_2": "SUITE 215",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143210",
            "telephone_number": "408-996-7950",
            "fax_number": "408-996-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20380 TOWN CENTER LN",
            "address_2": "SUITE 215",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143210",
            "telephone_number": "408-996-7950",
            "fax_number": "408-996-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "GARRETT",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A74445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A744450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NA Wang, DDS
• Xiao Ping Wang, L.AC. O.M.D.
• Xichun Wang, DO
• Yiling Wang
• Yingying Wang
• Linda Suzanne Weaver, MFT
• Armin Webb, DPT
• Paige M Weisbrod
• Wellness Express Clinic, Inc.
• Wen S. Fan DMD, MD and Cheng DDS, MD (Cupertino Oral Surgery & Dental Implants)

• Child & Adolescent Psychiatry Physician in Cupertino, CA
• Providers in Cupertino, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.