WENDY WILEY (NPI# 1720192487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720192487 |
| Entity Type | Individual |
| Full Name | WENDY WILEY |
| Credential | PA |
| Practice Address |
3802 Main St Occidental CA 95465 |
| Mailing Address |
Po Box 1449 Guerneville CA 95446-1449 |
| Practice Telephone | 7078742444 |
| Practice Fax Number | 7078741664 |
| Mailing Telephone | 7078695977 |
| Mailing Fax Number | 7078695983 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA11243 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1598768962 | 05 | |
| CA | STATE LICENSE NUMBER | PA11243 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861776924 | Wendy Wiley | Social Worker | 2100 Comer Ave, Columbus, GA 31904-8725 | 2011-10-06 |
| Street Address |
3802 MAIN ST |
| City | OCCIDENTAL |
| State | CA |
| Zip Code | 95465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043419559 | Rain Moore | Family Medicine | 3802 Main St, Occidental, CA 95465 | 2007-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831604669 | Theresa Sheppard Alexander | Marriage & Family Therapist | 3944 Harmony Village Circle, Occidental, CA 95465 | 2017-12-01 |
| 1053540591 | Dianna D, Evans | Marriage & Family Therapist | 5187 Occidental Camp Meeker Road, Occidental, CA 95465 | 2009-07-06 |
| 1902019524 | Miriam Redstone | Social Worker | 18200 Willow Creek Road, Occidental, CA 95465 | 2007-05-08 |
| 1629113717 | Shari Liggett Kovner | Nurse Practitioner | 3802 Main St., Occidental, CA 95465 | 2007-02-20 |
| 1831107556 | Steven Louis Mcneal | Dentist | 4066 Bohemian Hwy, Occidental, CA 95465 | 2006-08-05 |
| 1093718413 | Kathleen O'brien | Social Worker | 3802 Main Street, Occidental, CA 95465 | 2005-05-31 |
| 1033403563 | Andriy Shevchuk | Dentist | 4066 Bohemian Hwy, Occidental, CA 95465 | 2011-06-01 |
| 1154659373 | Molly Rebecca Kirkconnell | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2009-11-28 |
| 1609878917 | Trina Bowen | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1427050731 | Victoria Davis | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| Find all providers in zip 95465 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | OCCIDENTAL |
| Zip Code | 95465 |
Please comment or provide details below to improve the information on WENDY WILEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.