Dr. Mark W Wrathall, Psy.D.
Psychologist, Clinical in Corona, CA. Individual provider (NPI-1).
NPI number1043400518
StatusActive
Last updated in NPPESJul 31, 2007
Details
- NPI
- 1043400518
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark W Wrathall
- Credential
- Psy.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2007
- Last updated
- Jul 31, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY20023 | CA | Yes |
Practice location
16756 Chino Corona RdCorona, CA 92880-9508
Phone 909-597-1771
Mailing address
16756 Chino Corona RdCorona, CA 92880-9508
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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