Imanie S Wijayaratne, PSY.D.,M.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25044 Issued in CA

Practice address

1275 30TH St
San Diego, CA 92154-3476

Phone

(619) 205-6345

NPI assigned

Sep 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1598907487
  NPD

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1932358355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543476",
            "telephone_number": "619-205-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJAYARATNE",
        "first_name": "IMANIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSY.D.,M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Elizabeth Wight, M.D.
• Kristina Sciarrillo Wightkin, LMFT
• Thomas Edward Wightman Jr., PA-C
• Caitlin J Wigley
• Courtney Wigner, BCBA
• Pushpanjalie Wijeratne, MD
• Leslie Robin Wikholm, PTA
• Matthew Allen Wikler, M.D.
• Anne M. Wiklund, LCSW
• Denise Ann Wiksten, PHD, ATC

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.