Wylie Center - a Psychological Corporation

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

WYLIE CENTER - A PSYCHOLOGICAL CORPORATION

Practice address

4164 Brockton Ave
Riverside, CA 92501-3400

Phone

(951) 683-5193

Fax

(951) 683-6019

NPI assigned

Aug 5, 2020

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

Ceo

Phone

(951) 683-5193

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1669082590",
    "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": "WYLIE CENTER - A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "RUBINSON",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-683-5193",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Jiway Wu, PT, DPT
• Kevin Wu, DPT
• Leslie Wu
• Christopher Don Wyatt, LCSW
• Katherine Wyatt, NP
• Mary Lukens Wyman, LCSW
• Theodore Eugene Wyman, M.D.
• Lucas Ryan Wymore, MD
• Joanne T. Wyszomirski-Witkowski, MD
• Novanh Scott Xayarath, MFT

• Behavior Analyst in Riverside, CA
• Providers in Riverside, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.