DR. SAMANTHA DEWITT WILSON (PSYD, LCSW) – Clinical Neuropsychologist, NPI 1881823045
Clinical Neuropsychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,434 CLINICAL PSYCHOLOGIST in CA
Provider Addresses for DR. SAMANTHA DEWITT WILSON (PSYD, LCSW)
10085 CARROLL CANYON RD STE 200H
SAN DIEGO, CA 921311100
Phone: (858) 208-3463
Type: Location
785 Grand Ave Ste 212
Carlsbad, CA 920082371
Phone: (760) 453-7175
Type: Location
9445, Farnham Street, San Diego, San Diego County, California, 92123, United States
SAN DIEGO, CA 921231308
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-11-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230524003185 | I | Clinical Social Worker | CA | TBD |
| I20231116001119 | I | Clinical Psychologist | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92131)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | CA | |
| Marriage And Family Therapist | CA | |
| Clinical Psychologist | CA | |
| Clinical Psychologist | CA | |
| Marriage And Family Therapist | CA | |
| Marriage And Family Therapist | CA | |
| Marriage And Family Therapist | CA |
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