Frederick Wycoco, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95010473 Issued in CA

Practice address

446 Alta Rd # 5300
San Diego, CA 92158-0001

Phone

(619) 661-2789

Fax

(505) 499-4988

NPI assigned

Feb 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wyco-Care, Aprn, Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1174343933
  NPD Authorized official
• Operation Samahan, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1194616268
  NPD (past)

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1609331560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 ALTA RD # 5300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921580001",
            "telephone_number": "619-661-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 ALTA RD # 5300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921580001",
            "telephone_number": "619-661-2789",
            "fax_number": "505-499-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCOCO",
        "first_name": "FREDERICK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-05",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010473",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95010473",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "79465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilynn Patten Wyatt, PT
• Tynan Wyatt, M.D.
• Zointrikca Twyshawn Wyatt, LMFT
• Arpal Wybourn, NP
• Christopher Anthony Wybourn, MD
• Ann Ryan Wycoff
• Gary Joseph Wyer
• Sarah Jean Wyles
• Jake Wylie
• Justin Jay Wylie

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.

Verify at the official NPI Registry.