DR. PHYLIS JANE WAKEFIELD PH.D.
NPI 1811047780
Psychologist - Addiction (Substance Use Disorder) in Sonoma, CA

Q: What is Phylis Wakefield's NPI number?

The NPI number for Phylis Wakefield is 1811047780. It was assigned to this individual provider in the NPPES registry on January 11, 2007.

Q: What is Phylis Wakefield's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Q: Is Phylis Wakefield enrolled in Medicare?

No. Phylis Wakefield has opted out of Medicare through February 6, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Phylis Wakefield was last updated on March 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since January 11, 2007Opted out of Medicare · through Feb 6, 2027

1151 BROADWAY, SUITE 202, SONOMA, CA 95476(770) 722-2624 Get Directions Write a Review

NPPES record last updated: March 3, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Phylis Jane Wakefield Ph.d. NPPES

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

DR. PHYLIS JANE WAKEFIELD PH.D. (NPI 1811047780) is an individual addiction (substance use disorder) provider in Sonoma, California, licensed in California (PSY14649) and active in the NPI registry since January 2007. She has opted out of Medicare through February 6, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1811047780

Entity TypeIndividualFemale

Primary Taxonomy103TA0400X

Provider Legal NameDR. PHYLIS JANE WAKEFIELDCredential: PH.D.

Location Address1151 BROADWAY, SUITE 202Sonoma, CA 95476-7571

Mailing AddressPo Box 97Sonoma, CA 95476-0097 · (707) 222-6242

Phone(770) 722-2624

Sole ProprietorYes

Enumeration DateJanuary 11, 2007

Last NPPES UpdateMarch 3, 2010

✔ NPI 1811047780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code103TA0400X

License✔ Licensed in CA · PSY14649

Definition

A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License PSY14649 (CA)

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY14649 (CA)

Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X · License PSY14649 (CA)

1151 BROADWAY, Sonoma, CA 95476

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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

Dr. Phylis Jane Wakefield Ph.d. 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 February 6, 2017 through February 6, 2027.

Opt-Out Effective DateFebruary 6, 2017

Opt-Out In Effect ThroughFebruary 6, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELE ROUSE

Marriage & Family Therapist

1151 BROADWAY, SUITE 102
SONOMA, CA 95476

Sonoma County (707) 339-2166

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 Phylis Wakefield's NPI number?

The NPI number for Phylis Wakefield is 1811047780. It was assigned to this individual provider in the NPPES registry on January 11, 2007.

Where is Phylis Wakefield located?

Phylis Wakefield practices at 1151 Broadway Suite 202, Sonoma, CA 95476. The listed phone number is (770) 722-2624.

What is Phylis Wakefield's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Is Phylis Wakefield enrolled in Medicare?

No. Phylis Wakefield has opted out of Medicare through February 6, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Phylis Wakefield was last updated on March 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.