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VIRTUAL REALITY MEDICAL CENTER
NPI 1396125456
Psychologist - Clinical in San Diego, CA

Active since June 04, 2015
6540 LUSK BLVD STE C115, SAN DIEGO, CA 92121(858) 642-0267 Get Directions Write a Review

NPPES record last updated: May 17, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Virtual Reality Medical Center NPPES

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

VIRTUAL REALITY MEDICAL CENTER (NPI 1396125456) is a healthcare organization registered as a clinical in San Diego, California and active in the NPI registry since June 2015. The organization lists Mark D Wiederhold, President, as its authorized official.

NPPES Registry Identity

NPI1396125456
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameVIRTUAL REALITY MEDICAL CENTER
Location Address6540 LUSK BLVD STE C115San Diego, CA 92121-2767
Mailing Address6540 Lusk Blvd Ste C115San Diego, CA 92121-2767 · (858) 642-0267
Phone(858) 642-0267
Organization SubpartNo
Authorized OfficialMark D WiederholdPresident · (858) 642-0267
Enumeration DateJune 4, 2015
Last NPPES UpdateMay 17, 2016
✔ NPI 1396125456 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 · PSY16840
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.
6540 LUSK BLVD STE C115, San Diego, CA 92121
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Virtual Reality Medical Center's NPI number?

The NPI number for Virtual Reality Medical Center is 1396125456. It was assigned to this organization in the NPPES registry on June 4, 2015.

Where is Virtual Reality Medical Center located?

Virtual Reality Medical Center is located at 6540 Lusk Blvd Ste C115, San Diego, CA 92121. The listed phone number is (858) 642-0267.

What is Virtual Reality Medical Center's specialty?

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

When was this NPI record last updated?

The NPPES record for Virtual Reality Medical Center was last updated on May 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.