Organization Active NPI

Detwiler Psychology Apc

  • Clinical Psychologist
  • Palm Springs, CA
National Provider Identifier
1912449430
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28289 Issued in CA
Legal business name
DETWILER PSYCHOLOGY APC
Practice address
471 E Tahquitz Canyon Way
219
Palm Springs, CA 92262-6620
Phone
(619) 636-9444
NPI assigned
Nov 15, 2016
Last updated
Nov 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Dr. Wesley William Detwiler, PHDNPI 1275686537
Title
Psychologist
Phone
(619) 636-9444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY28289 CA Primary

Addresses

Primary practice location

471 E Tahquitz Canyon Way
219
Palm Springs, CA 92262-6620

Mailing address

471 E Tahquitz Canyon Way
219
Palm Springs, CA 92262-6620
Phone (619) 636-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200928002632 CA Part B Supplier - Clinic/Group Practice 0749609535 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Springs, CA

National Provider Directory

National Provider Directory

Locations

471 E Tahquitz Canyon Way
Ste 219
Palm Springs, CA 92262
Phone (619) 636-9444

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1912449430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 E TAHQUITZ CANYON WAY",
            "address_2": "219",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626620",
            "telephone_number": "619-636-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 E TAHQUITZ CANYON WAY",
            "address_2": "219",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626620",
            "telephone_number": "619-636-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETWILER PSYCHOLOGY APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "DETWILER",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "619-636-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.