CAROLYN E. WYLIE CENTER (NPI# 1972838670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972838670 |
| Entity Type | Organization |
| Organization Name | CAROLYN E. WYLIE CENTER |
| Practice Address |
4161 Brockton Avenue Riverside CA 92501 |
| Mailing Address |
3915 La Sierra Ave Apt 35 Riverside CA 92505-3550 |
| Practice Telephone | 9516835193 |
| Practice Fax Number | 9516836019 |
| Mailing Telephone | 9516835193 |
| Mailing Fax Number | 9516836019 |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2009-10-14 |
| Authorized Official Name | MRS. LISA MARIE DRYAN (DIRECTOR OF MENTAL HEALTH SERVICES) |
| Authorized Official Telephone | 9516835193 |
| Authorized Official Credential | LSC 18668 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 60910 | CA | Managed Care Organizations |
| Street Address |
4161 BROCKTON AVENUE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
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| 1861624132 | County of Riverside Department of Mental Health | Point of Service | 9990 County Farm Rd Ste 6, Riverside, CA 92503-3542 | 2009-08-20 |
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| Find all providers with the same taxonomy | ||||
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| 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.