Theodore B. Wyatt Jr.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

11175 Azusa CT Ste 110
Rancho Cucamonga, CA 91730-4933

Phone

(503) 330-3708

NPI assigned

May 19, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1831028471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 AZUSA CT STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304933",
            "telephone_number": "503-330-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 AZUSA CT STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304933",
            "telephone_number": "503-330-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "THEODORE",
        "middle_name": "B.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wtfootcare, Professional Physician Assistant Corporation
• Dan Wu, DAIM,L.AC.
• Kimberly Wu
• Qi Wu
• Melva Sosa Wyatt, DDS
• Rachel Lynn Wyles-de Ryk, COTA
• Steve Robert Wysocki, PH.D.
• Jackson Xia
• Rongrong Xiang, RBT
• Monica B Xie, NP

• In Home Supportive Care Agency in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.