Eden Wylie

Individual provider Active NPI Rehabilitation Counselor · Richvale, CA

NPI 1801493754 · NPPES record last updated Oct 5, 2020

Key facts

NPI
1801493754
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Counselor 225C00000X
Practice address
1229 Broadway St
Richvale, CA 95974-9597
Phone
(530) 882-4125
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Environmental Alternatives Past
since Oct 11, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X Yes

Addresses

Primary practice location

1229 Broadway St
Richvale, CA 95974-9597

Mailing address

455 Main St
Quincy, CA 95971-9120
Phone (530) 283-3330

Other providers in Richvale, CA

All providers in Richvale, CA · Rehabilitation Counselor in California

Sources for this page

Verify at the official NPI Registry.