Renee E Wyatt

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW73963 Issued in CA

Practice address

200 Pine Ave
Long Beach, CA 90802-3041

Phone

(424) 599-1476

NPI assigned

Mar 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1306966619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PINE AVE STE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023039",
            "telephone_number": "424-599-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023041",
            "telephone_number": "424-599-1476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624284",
            "country_code": "US",
            "telephone_number": "310-639-5983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "RENEE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW73963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sing-Yung Wu, M.D.
• Stephanie Wu, PHARM.D.
• Timothy Farn Wu, PHARMD
• Laura Jacquline Wuerz
• Dominique Wurts
• Rosanna Wyatt
• Sandhi Wynn, NP
• Wynning Foundation, Inc.
• Xcell Surgery Center LLC
• Sammy Xian, DPM

• Mental Health Counselor in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.