Wiley Dewayne Sutton, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY4467 Issued in CA

Practice address

4000 Long Beach Blvd
Long Beach, CA 90807-2617

Phone

(562) 595-7102

Fax

(562) 595-9112

NPI assigned

May 31, 2008

Last updated

May 31, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Psychshield Corporation

  dba Psychshield Behavioral Healthcare

  • Adult Mental Health Clinic/Center
  • Long Beach, CA
  • NPI 1437358520
  Authorized official Same address or phone

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212192000000",
    "number": "1932367380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907140250",
            "telephone_number": "562-595-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LONG BEACH BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072617",
            "telephone_number": "562-595-7102",
            "fax_number": "562-595-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "WILEY",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2008-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Sutherland, M.D.
• Amy Michelle Sutton
• Bobbi Sutton, B.S.
• Deboria Sutton, R.N.
• Lindsey Anne Sutton, CCC-SLP
• Suzan Khajavi DDS, Inc
• Maja Svenson, CADC-CAS
• David K. Svigals, PHARM.D.
• Skye Swain
• Jennifer Swan, LCSW

• Clinical Psychologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.