The Carolyn E. Wylie Center for Children, Youth & Families

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

THE CAROLYN E. WYLIE CENTER FOR CHILDREN, YOUTH & FAMILIES

Practice address

4164 Brockton Ave
Riverside, CA 92501-3400

Phone

(951) 683-5193

Fax

(951) 300-1030

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Pamela G Jordan, LCSW, MSLM

Title

Chief Executive Officer

Phone

(951) 683-5193

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Wylie Center Doing business as

Tax ID family

The Carolyn E Wylie Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Carolyn E. Wylie Center

  • Point of Service
  • Riverside, CA
  • NPI 1972838670
  NPD tax ID
• The Carolyn E. Wylie Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverside, CA
  • NPI 1437273521
  NPD tax ID
• The Carolyn E. Wylie Center

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1902218696
  NPD tax ID
• The Carolyn E.Wylie Center for Children, Youth & Families

  • Local Education Agency (LEA)
  • Riverside, CA
  • NPI 1831377506
  NPD tax ID
• Wylie Center

  • Community/Behavioral Health Agency
  • Nuevo, CA
  • NPI 1568796969
  NPD tax ID

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831237932",
    "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": "951-300-1030"
        },
        {
            "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": "951-300-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CAROLYN E. WYLIE CENTER FOR CHILDREN, YOUTH & FAMILIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "951-683-5193",
        "authorized_official_credential": "LCSW, MSLM"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAT",
            "identifier": "33BAA0",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACT",
            "identifier": "33BA00",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wylie Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Benin Medical Corporation
• The C.a.U.S.E. Approach
• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center
• The Carolyn E.Wylie Center for Children, Youth & Families
• The Chaun Collective
• The Children'S Doctor Professional Corporation
• The Dental Office on Magnolia, Inc
• The Diet Duchess LLC

• Local Education Agency (LEA) in Riverside, CA
• Providers in Riverside, CA by specialty
• Local Education Agency (LEA) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.