Active NPI
Cheri Dianne Wheeler, PH.D.
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1861615783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21392
- Practice address
- 2670 S White Rd
Suite 245
San Jose, CA 95148-2071 - Phone
- (408) 833-5739
- Fax
- (408) 528-8939
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- 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 | 21392 | CA | Primary |
Addresses
Primary practice location
2670 S White Rd
Suite 245
San Jose, CA 95148-2071
Mailing address
2670 S White Rd
Suite 245
San Jose, CA 95148-2071
Phone (408) 833-5739
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY213920 | Medicaid | CA | |
| OPL213920 | Other | CA | BLUE SHIELD OF CALIFORNIA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070609000149 | CA | Practitioner - Clinical Psychologist | 4880792134 | Practice locations: San Jose, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2670 S White Rd
Suite 245
San Jose, CA 95148-2085
Phone (408) 833-5739
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21392 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1861615783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2670 S WHITE RD",
"address_2": "SUITE 245",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951482071",
"telephone_number": "408-833-5739",
"fax_number": "408-528-8924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2670 S WHITE RD",
"address_2": "SUITE 245",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951482071",
"telephone_number": "408-833-5739",
"fax_number": "408-528-8939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "CHERI",
"middle_name": "DIANNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "21392",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY213920",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CALIFORNIA",
"identifier": "OPL213920",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.