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MATTHEW JOHN WYNN PHD
NPI 1013777036
Psychologist - Clinical in Piedmont, CA

Active since March 19, 2024Opted out of Medicare · through Mar 19, 2028
539 BLAIR AVE, PIEDMONT, CA 94611(510) 519-1928 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Matthew John Wynn Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW JOHN WYNN PHD (NPI 1013777036) is an individual clinical provider in Piedmont, California, licensed in California (34922) and active in the NPI registry since March 2024. He has opted out of Medicare through March 19, 2028.

NPPES Registry Identity

NPI1013777036
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameMATTHEW JOHN WYNNCredential: PHD
Location Address539 BLAIR AVEPiedmont, CA 94611-3734
Mailing AddressPo Box 11396Oakland, CA 94611-0396
Phone(510) 519-1928
Sole ProprietorYes
Enumeration DateMarch 19, 2024
NPPES CertifiedMarch 19, 2024
✔ NPI 1013777036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 34922
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
539 BLAIR AVE, Piedmont, CA 94611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Matthew John Wynn Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 19, 2024 through March 19, 2028.

Opt-Out Effective DateMarch 19, 2024
Opt-Out In Effect ThroughMarch 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Wynn's NPI number?

The NPI number for Matthew Wynn is 1013777036. It was assigned to this individual provider in the NPPES registry on March 19, 2024.

Where is Matthew Wynn located?

Matthew Wynn practices at 539 Blair Ave, Piedmont, CA 94611. The listed phone number is (510) 519-1928.

What is Matthew Wynn's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Matthew Wynn enrolled in Medicare?

No. Matthew Wynn has opted out of Medicare through March 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Matthew Wynn was last updated on March 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.