Individual provider Active NPI

Kristen Wheldon

  • Forensic Psychologist
  • South Pasadena, CA
National Provider Identifier
1881901080
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
PSY27027 Issued in CA
Practice address
1800 Fair Oaks Ave Ste C
South Pasadena, CA 91030-4778
Phone
(657) 226-1447
NPI assigned
Sep 9, 2010
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X PSY27027 CA Primary

Addresses

Primary practice location

1800 Fair Oaks Ave Ste C
South Pasadena, CA 91030-4778

Mailing address

1800 Fair Oaks Ave Ste C
South Pasadena, CA 91030-4778
Phone (657) 226-1447

Other practice location 1

Hwy 1
San Luis Obispo, CA 93409-8101
Phone (805) 547-7900 ext. 4121

Other names 1

  • Kristen Wheldon Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL theranest.com

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
I20200609001489 CA Practitioner - Clinical Psychologist 8921429473

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1800 Fair Oaks Ave C
South Pasadena, CA 91030-4778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY27027CAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheldon Psychological Services, Inc. CurrentSince Mar 18, 2020 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Locations

1800 Fair Oaks Ave
Ste C
South Pasadena, CA 91030
Phone (626) 792-4747

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1881901080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FAIR OAKS AVE STE C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304778",
            "telephone_number": "657-226-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FAIR OAKS AVE STE C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304778",
            "telephone_number": "657-226-1447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hwy 1",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934098101",
            "country_code": "US",
            "telephone_number": "805-547-7900 x4121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHELDON",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY27027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "theranest.com",
            "affiliation": "N",
            "address_1": "1800 Fair Oaks Ave Ste C",
            "city": "South Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910304778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WHELDON",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.