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General NPI Number Information
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NPI Number | 1457669798
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Entity Type | Individual
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Provider Name | JAMIE ANNETTE WHALEN PSY.D
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Gender | Female
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 3651 E BASELINE RD STE E-204
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City | GILBERT
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State | AZ
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Zip | 85234-2689
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Country | US
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Telephone | 480-272-4740
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Fax | 480-633-7788
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Provider Business Mailing Address
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Address Line | 3651 E BASELINE RD STE E-204
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City | GILBERT
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State | AZ
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Zip | 85234-2689
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Country | US
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Telephone | 480-272-4740
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Fax | 480-633-7788
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSB-35421
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4316
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License Number State | AZ
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