Individual provider Active NPI

Michele Wilkens, PSY.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1942324314
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25549 Issued in CA
Practice address
65 N Madison Ave Ste 601
Pasadena, CA 91101-2047
Phone
(323) 375-8175
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25549 CA Primary

Addresses

Primary practice location

65 N Madison Ave Ste 601
Pasadena, CA 91101-2047

Mailing address

65 N Madison Ave Ste 601
Pasadena, CA 91101-2047
Phone (323) 375-8175

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
I20150922000864 CA Practitioner - Clinical Psychologist 4385951292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

65 N Madison Ave
Suite 601
Pasadena, CA 91101-2047
Phone (323) 375-8175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25549CAMDClinical Psychologist
25549CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Michele Wilkens PSYD a Psychological Corporation Clinical CurrentSince Jul 29, 2015 Accepting new patients

Locations

3171 Los Feliz Blvd
Ste 311B
Los Angeles, CA 90039

65 N Madison Ave
Ste 601
Pasadena, CA 91101
Phone (323) 375-8175

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1942324314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 601",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012047",
            "telephone_number": "323-375-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 601",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012047",
            "telephone_number": "323-375-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKENS",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.