Physician Compare National (NPI:1649826595)

HEALTHCARE PROVIDER: EMILY WILHITE

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1649826595
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406287721
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200520001784
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILHITE
	Individual professional last name
Provider First Name	EMILY
	Individual professional first name
Provider Middle Name	ROSE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4907 MORENA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1412
	Group Practice or individual's line 2 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921177391
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y