Active NPI
Sydney Wyatt
- Psychiatry Physician
- Sacramento, CA
National Provider Identifier
1568081859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 13484
- Practice address
- 4150 V St # 1100
Sacramento, CA 95817-1460 - Phone
- (916) 734-2737
- NPI assigned
- Apr 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 13484 | CA | Primary |
Addresses
Primary practice location
4150 V St # 1100
Sacramento, CA 95817-1460
Mailing address
19405 TG Nation Way
Harrah, OK 73045-6333
Phone (405) 395-8380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240307004310 | CA | Order and Referring Only - Internal Medicine | 9537505979 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13484 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Interoperability endpoints
- swyatt589972@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714780800000",
"number": "1568081859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19405 TG NATION WAY",
"city": "HARRAH",
"state": "OK",
"postal_code": "730456333",
"telephone_number": "405-395-8380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 V ST # 1100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171460",
"telephone_number": "916-734-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "SYDNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-16",
"last_updated": "2024-05-04",
"certification_date": "2024-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "13484",
"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 May 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.