Individual provider Active NPI

Paul Douglas Wyatt, ED.D.

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1073576690
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 3094 Issued in CA
Practice address
828 University Ave
Sacramento, CA 95825-6723
Phone
(916) 565-1919
Fax
(916) 488-2919
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 3094 CA Primary

Addresses

Primary practice location

828 University Ave
Sacramento, CA 95825-6723

Mailing address

2271 University Ave
Sacramento, CA 95825-7083
Phone (916) 488-2919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 3094CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073576690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 UNIVERSITY AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958257083",
            "telephone_number": "916-488-2919",
            "fax_number": "916-488-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 UNIVERSITY AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256723",
            "telephone_number": "916-565-1919",
            "fax_number": "916-488-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "PAUL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 3094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.