Marsha Wendy Von Wiederhold, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY15420 Issued in CA

Practice address

2504 Clay St
San Francisco, CA 94115-1811

Phone

(415) 442-1968

NPI assigned

May 17, 2017

Sex

Female

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)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1952838211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 CLAY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151811",
            "telephone_number": "415-442-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CLAY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151811",
            "telephone_number": "415-442-1968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 Main St",
            "address_purpose": "LOCATION",
            "city": "Saint Helena",
            "state": "CA",
            "postal_code": "945741940",
            "country_code": "US",
            "telephone_number": "415-442-1968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON WIEDERHOLD",
        "first_name": "MARSHA",
        "middle_name": "WENDY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tho Vong
• Vivian Vong

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.