Wendy Wiley, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA11243 Issued in CA

Practice address

3802 Main St
Occidental, CA 95465

Phone

(707) 874-2444

Fax

(707) 874-1664

NPI assigned

Aug 19, 2006

Last updated

Jun 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: wendy.wiley@wchealth.eclinicaldirectplus.com

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

• West County Health Centers, Inc.

  dba Occidental Area Health Center

  • Federally Qualified Health Center (FQHC)
  • Occidental, CA
  • NPI 1598768962
  NPD (past)
• West County Health Centers, Inc.

  dba Gravenstein South

  • Federally Qualified Health Center (FQHC)
  • Sebastopol, CA
  • NPI 1841916889
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1720192487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954461449",
            "telephone_number": "707-869-5977",
            "fax_number": "707-869-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 MAIN ST",
            "city": "OCCIDENTAL",
            "state": "CA",
            "postal_code": "95465",
            "telephone_number": "707-874-2444",
            "fax_number": "707-874-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "WENDY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA11243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA11243",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598768962",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen O'Brien, LCSW
• Monique Mari Parrish, LCSW
• Audrey Rees, LM, CPM
• Andriy Shevchuk, DDS
• West County Health Centers, Inc. (Occidental Area Health Center)
• Megan Wilson
• Birgit Magdalena Wolz, PHD

• Medical Physician Assistant in Occidental, CA
• Providers in Occidental, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.