Individual provider Active NPI

Patti L Wiley, MFT

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1619135019
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT29345 Issued in CA
Practice address
1760 Solano Ave
Suite 200
Berkeley, CA 94707-2218
Phone
(510) 525-2277
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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 MFT29345 CA Primary

Addresses

Primary practice location

1760 Solano Ave
Suite 200
Berkeley, CA 94707-2218

Mailing address

1760 Solano Ave
Suite 200
Berkeley, CA 94707-2218
Phone (510) 525-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 24, 2024 through Jul 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT29345CAMDMarriage & Family Therapist
29345CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1619135019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 SOLANO AVE",
            "address_2": "SUITE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072218",
            "telephone_number": "510-525-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 SOLANO AVE",
            "address_2": "SUITE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072218",
            "telephone_number": "510-525-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "PATTI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT29345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.