Timothy Earl Wiley, RDO

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

D3539 Issued in CA

Practice address

227 N Jackson Ave
San Jose, CA 95116-1603

Phone

(408) 729-7115

Fax

(408) 729-7115

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750596755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S BAYWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283310",
            "telephone_number": "408-985-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-729-7115",
            "fax_number": "408-729-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "TIMOTHY",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "RDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "CA",
            "license": "D3539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1713912",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Wilcox
• Haley Wild
• Kim Margaret Wilder, MSW,CPRP
• Amber Wiley
• Brianna Wiley
• Kelly Wilhelm
• Briana Rose Evangelista Wilkerson
• Jaden Wilkes, LMFT, APCC
• Russell Wilkie, MFT
• Alicia Nicole Wilkins

• Technician/Technologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Technician/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.