Provider Demographics
NPI:1144490137
Name:WORRELL, WENDY EYLER (PSYD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:EYLER
Last Name:WORRELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 FRANCISCO DR STE 140-231
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-3713
Mailing Address - Country:US
Mailing Address - Phone:916-204-8757
Mailing Address - Fax:
Practice Address - Street 1:4401 KRUK TRL
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9276
Practice Address - Country:US
Practice Address - Phone:916-204-8757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18526103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical