Individual provider Active NPI

Woodwyn Woodwyn Koons, PSY.D.

  • Clinical Psychologist
  • Santa Barbara, CA
National Provider Identifier
1902487374
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32147 Issued in CA
Practice address
21 E Canon Perdido St Ste 211a
Santa Barbara, CA 93101-2282
Phone
(805) 770-1550
NPI assigned
Apr 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY32147 CA Primary

Addresses

Primary practice location

21 E Canon Perdido St Ste 211a
Santa Barbara, CA 93101-2282

Mailing address

754 Alameda Padre Serra
Santa Barbara, CA 93103-2139
Phone (646) 279-6391

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
I20210811004372 CA Practitioner - Clinical Psychologist 0042614158 Practice locations: Santa Barbara, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 E Canon Perdido St
Suite 211a
Santa Barbara, CA 93101-2282
Phone (805) 770-1550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY32147CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1902487374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 ALAMEDA PADRE SERRA",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032139",
            "telephone_number": "646-279-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E CANON PERDIDO ST STE 211A",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012282",
            "telephone_number": "805-770-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONS",
        "first_name": "WOODWYN",
        "middle_name": "WOODWYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.