The Carolyn E. Wylie Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE CAROLYN E. WYLIE CENTER

Doing business as

The Wylie Center

Practice address

4164 Brockton Ave
Riverside, CA 92501-3400

Phone

(951) 683-5193

Fax

(951) 683-6019

NPI assigned

Mar 16, 2007

Last updated

Aug 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mickey Rubinson

Title

C.E.O.

Phone

(951) 683-5193

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Wylie Center Doing business as

Tax ID family

The Carolyn E Wylie Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Carolyn E. Wylie Center

  • Point of Service
  • Riverside, CA
  • NPI 1972838670
  NPD tax ID
• The Carolyn E. Wylie Center

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1902218696
  NPD tax ID
• The Carolyn E. Wylie Center for Children, Youth & Families

  dba The Wylie Center

  • Local Education Agency (LEA)
  • Riverside, CA
  • NPI 1831237932
  NPD tax ID
• The Carolyn E.Wylie Center for Children, Youth & Families

  dba The Wylie Center

  • Local Education Agency (LEA)
  • Riverside, CA
  • NPI 1831377506
  NPD tax ID
• Wylie Center

  • Community/Behavioral Health Agency
  • Nuevo, CA
  • NPI 1568796969
  NPD tax ID

Locations

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1437273521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4164 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013400",
            "telephone_number": "951-683-5193",
            "fax_number": "951-683-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4164 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013400",
            "telephone_number": "951-683-5193",
            "fax_number": "951-683-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CAROLYN E. WYLIE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "RUBINSON",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "951-683-5193",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "33BA00",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "33BAA0",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wylie Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Wylie Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Michelle Thayer, PA-C
• Susan Elizabeth Thayer, SUDCCII 9405
• Vincent Thayer, AMFT
• The Benin Medical Corporation (Benin Medical Corporation)
• The C.a.U.S.E. Approach
• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center for Children, Youth & Families (The Wylie Center)
• The Carolyn E.Wylie Center for Children, Youth & Families (The Wylie Center)
• The Chaun Collective

• Mental Health Clinic/Center (Including Community Mental Health Center) in Riverside, CA
• Providers in Riverside, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.