Jay Robert Wick, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT99744 Issued in CA

Practice address

4405 Manchester Ave Ste 103
Encinitas, CA 92024

Phone

(760) 448-0936

NPI assigned

Oct 15, 2012

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)

Not enrolled

State licenses

Practice roles

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.

• San Diego Youth Services

  • Voluntary or Charitable Agency
  • San Diego, CA
  • NPI 1366651366
  NPD (past)

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1992057988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE STE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244940",
            "telephone_number": "760-448-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE STE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-448-0936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 4th Ave",
            "address_2": "suite 301",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921012124",
            "country_code": "US",
            "telephone_number": "619-525-9903 x210",
            "fax_number": "619-525-9908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICK",
        "first_name": "JAY",
        "middle_name": "ROBERT",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-15",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT99744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Noelle White, RN, CLC
• Neysa Dale Whiteman, MD
• Kristin M Whiteside, PH.D.
• Matthew Raymond Whitmore
• Whole Life Home Health Care, Inc.
• Mary Berger Wiggins, LCSW
• Will & Chan Dental Corporation
• David A Willes
• Willett Medical Group
• Marti L. Willey, N.P.

• Marriage & Family Therapist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.