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General NPI Number Information
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NPI Number | 1962015628
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Entity Type | Individual
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Provider Name | GRAHAMM WIEST PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 26800 CROWN VALLEY PKWY STE 320
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City | MISSION VIEJO
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State | CA
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Zip | 92691-7320
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Country | US
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Telephone | 949-365-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 505 N EUCLID ST STE 300
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City | ANAHEIM
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State | CA
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Zip | 92801-5514
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Country | US
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Telephone | 714-871-5646
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 34353
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License Number State | CA
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