Individual provider Active NPI

Canzi Wang, PHD

  • Psychologist
  • Arcadia, CA
National Provider Identifier
1992053136
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30284 Issued in CA
Practice address
411 E Huntington Dr Ste 107-529
Arcadia, CA 91006-3731
Phone
(626) 539-3091
NPI assigned
Aug 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 30284 CA Primary

Addresses

Primary practice location

411 E Huntington Dr Ste 107-529
Arcadia, CA 91006-3731

Mailing address

411 E Huntington Dr Ste 107-529
Arcadia, CA 91006-3731
Phone (626) 539-3091

Other practice location 1

885 N San Antonio Rd Ste O
Los Altos, CA 94022-1341
Phone (650) 434-2563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mind & Body Garden, a Psychological Corporation Past Accepting new patients

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1992053136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E HUNTINGTON DR STE 107-529",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063731",
            "telephone_number": "626-539-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E HUNTINGTON DR STE 107-529",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063731",
            "telephone_number": "626-539-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "885 N San Antonio Rd Ste O",
            "address_purpose": "LOCATION",
            "city": "Los Altos",
            "state": "CA",
            "postal_code": "940221341",
            "country_code": "US",
            "telephone_number": "650-434-2563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CANZI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.